Department of Urology, Mayo Clinic Hospital, Phoenix, AZ.
Cancer Clinical Research, Mayo Clinic Hospital, Phoenix, AZ.
Urology. 2014 Jul;84(1):78-81. doi: 10.1016/j.urology.2014.04.009.
To evaluate the long-term safety of a novel continuous infusion of ketorolac vs placebo after laparoscopic donor nephrectomy.
We performed a secondary analysis of a previously reported randomized controlled trial conducted from October 7, 2008, to July 21, 2010. Patients aged 18-75 years received a continuous infusion of either ketorolac (treatment [n=57]) or normal saline (control [n=54]) for 24 hours immediately after laparoscopic donor nephrectomy. Serum creatinine levels were measured at 1- and 1.5-year follow-ups. Glomerular filtration rate was calculated preoperatively, postoperatively, and at 1- and 1.5-year follow-ups using the Chronic Kidney Disease Epidemiology Collaboration equation. Glomerular filtration rates were compared between treatment and control groups using 2-sample t tests.
Data analysis for the 111 donor nephrectomy patients showed that glomerular filtration rates decreased in both groups over time, but changes were not clinically significant. No difference was found in glomerular filtration rates (in mL/min/1.73 m2) between treatment and control groups at 1-year follow-up (89.29 vs 87.94 mL/min/1.73 m2; P=.58) or at 1.5-year follow-up (88.54 vs 90.25 mL/min/1.73 m2; P=.51).
The novel provision of continuous steady-state ketorolac is safe for postoperative pain control in patients after donor nephrectomy, with no change in glomerular filtration rates between treatment and control groups acutely and at up to 1.5-year follow-up.
评估腹腔镜供肾切术后新型持续输注酮咯酸与安慰剂的长期安全性。
我们对先前报道的一项随机对照试验进行了二次分析，该试验于 2008 年 10 月 7 日至 2010 年 7 月 21 日进行。18-75 岁的患者在腹腔镜供肾切术后立即接受酮咯酸（治疗组 [n=57]）或生理盐水（对照组 [n=54]）的 24 小时持续输注。在 1 年和 1.5 年随访时测量血清肌酐水平。使用慢性肾脏病流行病学合作方程计算术前、术后以及 1 年和 1.5 年随访时的肾小球滤过率。使用双样本 t 检验比较治疗组和对照组的肾小球滤过率。
对 111 例供肾切术患者的数据进行分析显示，两组的肾小球滤过率随时间推移均下降，但变化无临床意义。治疗组和对照组在 1 年随访时的肾小球滤过率（以 mL/min/1.73 m2 计）无差异（89.29 与 87.94 mL/min/1.73 m2；P=.58），在 1.5 年随访时也无差异（88.54 与 90.25 mL/min/1.73 m2；P=.51）。
新型持续输注酮咯酸可为供肾切术后患者提供术后镇痛，且在急性和 1.5 年随访时，治疗组和对照组的肾小球滤过率均无变化，这是安全的。
