Incidence of Hematoma Associated with Ketorolac after TRAM Flap Breast Reconstruction
Incidence of Hematoma Associated with Ketorolac after TRAM Flap Breast Reconstruction
复制标题
TRAM 皮瓣乳房再造术后与酮咯酸相关的血肿发生率
DOI：
--
复制
发表时间：
2001
影响因子：
3.6
通讯作者：
G. Reece
中科院分区：
文献类型：
--
作者：
S. Sharma;D. Chang;C. Koutz;G. Evans;G. Robb;H. Langstein;S. Kroll;G. Reece
酮罗拉酸经常被用作术后疼痛缓解的辅助药物，特别是在术后立即被麻醉师使用。它可以单独用作镇痛药，但更常用于增强吗啡或哌替啶等麻醉药的作用，以减少这些药物的总剂量和副作用。酮罗拉酸的生产厂家警告术后出血风险高的患者不要使用酮罗拉酸，以免增加血肿的风险，但对横腹直肌皮肤（TRAM）皮瓣患者的风险从未有过报道。在一项对215例接受TRAM皮瓣乳房重建术的患者进行的研究中，确定了静脉注射酮罗拉酸（n = 65）的患者（n = 65）使用患者控制的镇痛装置作为吗啡治疗的辅助治疗，比未接受酮罗拉酸的患者（n = 150；平均累积剂量，1.75 mg/kg; p = 0.02）需要更少的吗啡（平均累积剂量，1.39 mg/kg）。使用酮咯酸治疗的患者血肿发生率没有增加。本研究提供的数据表明，静脉注射酮罗拉酸确实减少了TRAM皮瓣乳房重建术患者对麻醉品的需要，而不会显著增加血肿的风险。(塑料。Reconstr。外科杂志107:352,2001。)
Ketorolac is frequently used as an adjunct for postoperative pain relief, especially by anesthesiologists during the immediate postoperative period. It can be used alone as an analgesic but is more often used to potentiate the actions of narcotics such as morphine or meperidine in an attempt to reduce the total dose and side effects of those drugs. The manufacturer of ketorolac cautions against its use in patients who have a high risk of postoperative bleeding, for fear of increasing the risk of hematoma, but the risk in transverse rectus abdominis musculocutaneous (TRAM) flap patients has never been reported. In a study of 215 patients who had undergone TRAM flap breast reconstruction, it was determined that patients who received intravenous ketorolac (n = 65) as an adjunct to their treatment with morphine administered by use of a patient‐controlled analgesia device required less morphine (mean cumulative dose, 1.39 mg/kg) than did patients who did not receive ketorolac (n = 150; mean cumulative dose, 1.75 mg/kg; p = 0.02). There was no increase in the incidence of hematoma in patients who were treated with ketorolac. The data presented in this study suggest that the use of intravenous ketorolac does reduce the need for narcotics administration in patients undergoing TRAM flap breast reconstruction, without significantly increasing the risk of hematoma. (Plast. Reconstr. Surg. 107: 352, 2001.)