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酮咯酸对机器人辅助腹腔镜根治性前列腺切除术患者术后导尿管相关膀胱不适的预防作用:一项随机、双盲、安慰剂对照研究。

Effect of Ketorolac on the Prevention of Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized, Double-Blinded, Placebo-Controlled Study.

作者信息

Park Jun-Young, Hong Jun Hyuk, Yu Jihion, Kim Doo-Hwan, Koh Gi-Ho, Lee Sang-A, Hwang Jai-Hyun, Kong Yu-Gyeong, Kim Young-Kug

机构信息

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.

Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.

出版信息

J Clin Med. 2019 May 29;8(6):759. doi: 10.3390/jcm8060759.

Abstract

Urinary catheterization can cause catheter-related bladder discomfort (CRBD). Ketorolac is widely used for pain control. Therefore, we evaluated the effect of ketorolac on the prevention of CRBD in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP). All patients were randomly allocated to the ketorolac group or the control group. The primary outcome was CRBD above a moderate grade at 0 h postoperatively. CRBD above a moderate grade at 1, 2, and 6 h was also assessed. Postoperative pain, opioid requirement, ketorolac-related complications, patient satisfaction, and hospitalization duration were also assessed. The incidence of CRBD above a moderate grade at 0 h postoperatively was significantly lower in the ketorolac group (21.5% vs. 50.8%, = 0.001) as were those at 1, 2, and 6 h. Pain scores at 0 and 1 h and opioid requirement over 24 h were significantly lower in the ketorolac group, while patient satisfaction scores were significantly higher in the ketorolac group. Ketorolac-related complications and hospitalization duration were not significantly different between the two groups. This study shows ketorolac can reduce postoperative CRBD above a moderate grade and increase patient satisfaction in patients undergoing RALP, suggesting it is a useful option to prevent postoperative CRBD.

摘要

导尿可导致导尿管相关膀胱不适(CRBD)。酮咯酸被广泛用于控制疼痛。因此,我们评估了酮咯酸对接受机器人辅助腹腔镜根治性前列腺切除术(RALP)患者预防CRBD的效果。所有患者被随机分配至酮咯酸组或对照组。主要结局是术后0小时中度以上的CRBD。还评估了术后1、2和6小时中度以上的CRBD。此外,还评估了术后疼痛、阿片类药物需求量、酮咯酸相关并发症、患者满意度和住院时间。酮咯酸组术后0小时中度以上CRBD的发生率显著低于对照组(21.5%对50.8%,P = 0.001),术后1、2和6小时的发生率也是如此。酮咯酸组术后0和1小时的疼痛评分以及24小时内的阿片类药物需求量显著更低,而酮咯酸组的患者满意度评分显著更高。两组之间酮咯酸相关并发症和住院时间无显著差异。本研究表明,酮咯酸可降低接受RALP患者术后中度以上的CRBD并提高患者满意度,提示其是预防术后CRBD的一个有用选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b46e/6616938/6890a5a5daaf/jcm-08-00759-g001.jpg

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