Dose-Related Effects and Bleeding Risk of Ketorolac in Pediatric Tonsillectomy.

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Do Hyun Kim, David W Jang, Se Hwan Hwang
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Abstract

Objective: To investigate the safety and effectiveness of dose-related ketorolac administration in children who underwent tonsillectomy.

Data sources: Data sourced from PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases, encompassing literature from their inception until June 2024.

Review methods: The perioperative administration of ketorolac in comparison with a control group was included in this analysis. The outcomes assessed were postoperative pain levels; utilization patterns of analgesic medication in terms of quantity and frequency; and the incidence rates of postoperative nausea, vomiting, and bleeding.

Results: Eighteen studies with 11,729 patients that investigated. The ketorolac treatment group with postoperative bleeding had a higher incidence of primary bleeding (significant bleeding and operative bleeding control) compared to the control group. However, ketorolac treatment did not affect the risk of secondary bleeding. Subgroup analysis showed that 0.9 to 1 mg/kg of ketorolac significantly increases primary operative control (odds ratio [OR] = 4.0700 [1.6352; 10.1302]; I2 = 0.0%) and primary significant bleeding (OR = 2.3200 [1.1322; 4.7538]; I2 = 0.0%). On the other hand, 0.5 mg/kg ketorolac did not show any influence on primary operative control. The administration of ketorolac (both 0.9-1 and 0.5 mg/kg) led to a significant decrease in postoperative pain (2-24 hours), nausea, and vomiting compared to the control group.

Conclusion: Low-dose (0.5 mg/kg) ketorolac administration to children could significantly reduce the risk of primary significant bleeding and surgical hemostasis compared to high-dose administration (0.9-1.0 mg/kg). In addition, low-dose ketorolac administration could provide sufficient pain control and reduce postoperative nausea and vomiting.

小儿扁桃体切除术中酮咯酸的剂量相关效应和出血风险
目的研究扁桃体切除术患儿服用与剂量相关的酮咯酸的安全性和有效性:数据来源:PubMed、SCOPUS、Embase、Web of Science 和 Cochrane 数据库,包括从开始到 2024 年 6 月的文献:本分析纳入了酮咯酸与对照组的围手术期用药对比。评估的结果包括:术后疼痛程度;镇痛药物使用的数量和频率模式;术后恶心、呕吐和出血的发生率:共有 18 项研究对 11 729 名患者进行了调查。与对照组相比,术后出血的酮咯酸治疗组的原发性出血(明显出血和手术出血控制)发生率更高。然而,酮咯酸治疗并不影响继发性出血的风险。亚组分析显示,0.9 至 1 毫克/千克的酮咯酸能显著提高原发性手术控制率(几率比 [OR] = 4.0700 [1.6352; 10.1302];I2 = 0.0%)和原发性显著出血率(OR = 2.3200 [1.1322; 4.7538];I2 = 0.0%)。另一方面,0.5 毫克/千克的酮咯酸对初次手术控制没有任何影响。与对照组相比,服用酮咯酸(0.9-1 毫克/千克和 0.5 毫克/千克)可显著减少术后疼痛(2-24 小时)、恶心和呕吐:结论:与大剂量给药(0.9-1.0 毫克/千克)相比,小剂量(0.5 毫克/千克)酮咯酸可显著降低儿童原发性大出血和手术止血的风险。此外,小剂量酮咯酸还能充分控制疼痛,减少术后恶心和呕吐。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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