Prognostic Impact and Safety of Ketorolac Tromethamine in Tibial Plateau Fracture Patients Undergoing Open Reduction and Internal Fixation.

IF 0.9 4区医学 Q3 SURGERY

Annali italiani di chirurgia Pub Date : 2025-01-01 DOI:10.62713/aic.3895

Kai Lin, Weiping Zheng, Jinyi Zhu, Xiaoyong Zhang, Xinxiang Jiang, Zhenzhong Ding, Zongyao Duan

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引用次数: 0

Abstract

Aim: To evaluate the postoperative analgesic efficacy and safety of ketorolac tromethamine in tibial plateau fracture (TPF) patients undergoing open reduction and internal fixation (ORIF) surgery.

Methods: This retrospective cohort study included 194 TPF patients treated at Dongtai People's Hospital between October 2022 and March 2024. Patients meeting the inclusion criteria were divided into two groups: the ketorolac tromethamine group (n = 104), who received ketorolac tromethamine combined with imrecoxib, and the control group (n = 90), who received imrecoxib alone after ORIF. Baseline characteristics, postoperative analgesia (measured using the visual analogue scale (VAS) and Ramsay sedation scores), fracture healing parameters (healing time, alkaline phosphatase (ALP), bone gamma-carboxyglutamate protein (BGP), and collagen type I carboxy-terminal propeptide (PICP), and adverse events were evaluated preoperatively and at hospital discharge.

Results: The ketorolac tromethamine group demonstrated significantly lower VAS scores (1 h, p = 0.017; 6 h, p = 0.022) and Ramsay sedation scores (1 h, p = 0.017; 6 h, p = 0.034) after anesthesia recovery compared to the control group. No significant differences between the two groups were observed in fracture healing time, ALP, BGP, or PICP levels (p > 0.05). The incidence of adverse events was comparable between the groups (p > 0.05). Laboratory results, including routine blood tests (neutrophil-to-lymphocyte ratio, p = 0.080; hemoglobin, p = 0.830), liver function tests (alanine aminotransferase (ALT), p = 0.773; aspartate aminotransferase (AST), p = 0.629), and renal function markers (creatinine, p = 0.596; uric acid (UA), p = 0.466; β2-microglobulin, p = 0.605), exhibited no significant differences between the two groups.

Conclusions: The combination of ketorolac tromethamine and imrecoxib was more effective than imrecoxib alone in alleviating postoperative pain in TPF patients undergoing ORIF. Ketorolac tromethamine had no significant impact on bone healing, indicating its potential as bone-safe analgesia when combined with imrecoxib.

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酮咯酸tromeamine对胫骨平台骨折切开复位内固定患者预后的影响及安全性。

目的：评价酮洛拉克tromeamine在胫骨平台骨折（TPF）切开复位内固定（ORIF）术后的镇痛效果和安全性。方法：回顾性队列研究纳入东台市人民医院于2022年10月至2024年3月期间收治的194例TPF患者。符合纳入标准的患者分为两组：酮咯酸tromeamine组（n = 104），接受酮咯酸tromeamine联合imrecoxib治疗；对照组（n = 90），在ORIF后单独接受imrecoxib治疗。评估基线特征、术后镇痛（使用视觉模拟量表（VAS）和Ramsay镇静评分测量）、骨折愈合参数（愈合时间、碱性磷酸酶（ALP）、骨γ -羧谷氨酸蛋白（BGP）、ⅰ型胶原羧基端前肽（PICP））以及术前和出院时的不良事件。结果：酮洛酸三聚氰胺组VAS评分显著低于对照组(1 h, p = 0.017；6 h, p = 0.022)和Ramsay镇静评分(1 h, p = 0.017；6 h, p = 0.034)，与对照组比较。两组骨折愈合时间、ALP、BGP、PICP水平比较差异无统计学意义（p < 0.05）。两组间不良事件发生率具有可比性（p < 0.05）。实验室结果，包括常规血液检查(中性粒细胞与淋巴细胞比率，p = 0.080；血红蛋白，p = 0.830)，肝功能检查(丙氨酸转氨酶（ALT）， p = 0.773；谷草转氨酶（AST）， p = 0.629)和肾功能指标(肌酐，p = 0.596；尿酸（UA）， p = 0.466；β2-微球蛋白，p = 0.605)，两组间无显著差异。结论：酮洛拉克氨三嗪联合不瑞昔布对TPF患者术后疼痛的缓解效果优于单用不瑞昔布。酮咯酸tromethamine对骨愈合无显著影响，表明其与imrexib联合使用时可能成为骨安全镇痛药。

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

Annali italiani di chirurgia 医学-外科

CiteScore

0.90

自引率

12.50%

发文量

116

审稿时长

>12 weeks

期刊介绍： Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.