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取卵时常规使用酮咯酸可使术后麻醉剂使用量减少超过50%。

Routine ketorolac at oocyte retrieval decreases postoperative narcotic use by more than 50.

作者信息

Seidler Emily A, Vaughan Denis A, Leung Angela Q, Sakkas Denny, Ryley David A, Penzias Alan S

机构信息

Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, Massachusetts.

Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, 25 Shattuck Street Boston, Massachusetts.

出版信息

F S Rep. 2021 Feb 10;2(2):156-160. doi: 10.1016/j.xfre.2021.02.003. eCollection 2021 Jun.

Abstract

OBJECTIVE

To study the impact of routine ketorolac administration during oocyte retrieval on the proportion of patients who require postoperative narcotics for analgesia.

DESIGN

Retrospective cohort study.

SETTING

Single, university-affiliated infertility clinic.

PATIENTS

All women undergoing oocyte retrieval between July and November 2016 (non-ketorolac group [NKG]; n = 826) and April-August 2017 (ketorolac group, KG; n = 1780).

INTERVENTIONS

A single 30 mg intravenous dose of ketorolac was administered after the oocyte retrieval procedure.

MAIN OUTCOME MEASURES

The number of patients who required postoperative narcotic analgesia, postoperative complication rate, and fresh embryo transfer pregnancy outcomes were examined.

RESULTS

In the KG, we found a significant decrease in the patients who required narcotics after oocyte retrieval compared with the NKG (12% KG vs. 25.5% NKG). We found no significant change in the clinical pregnancy rate (CPR) resulting from fresh embryo transfer after our intervention (NKG CPR 32.6%, KG CPR 32.4%). Furthermore, there was no increase in postoperative bleeding complications in the KG.

CONCLUSIONS

Routine use of ketorolac at the time of oocyte retrieval may decrease the rate of postoperative opioid use without adversely impacting pregnancy and complication rates.

摘要

目的

研究在取卵过程中常规使用酮咯酸对术后需要使用麻醉性镇痛药的患者比例的影响。

设计

回顾性队列研究。

地点

一所大学附属医院的单一不孕不育诊所。

患者

2016年7月至11月接受取卵的所有女性(非酮咯酸组[NKG];n = 826)以及2017年4月至8月接受取卵的女性(酮咯酸组,KG;n = 1780)。

干预措施

在取卵手术后静脉注射单次30 mg酮咯酸。

主要观察指标

检查术后需要麻醉性镇痛的患者数量、术后并发症发生率以及新鲜胚胎移植的妊娠结局。

结果

在酮咯酸组中,我们发现与非酮咯酸组相比,取卵后需要使用麻醉性镇痛药的患者显著减少(酮咯酸组为12%,非酮咯酸组为25.5%)。我们发现干预后新鲜胚胎移植导致的临床妊娠率(CPR)没有显著变化(非酮咯酸组CPR为32.6%,酮咯酸组CPR为32.4%)。此外,酮咯酸组术后出血并发症没有增加。

结论

取卵时常规使用酮咯酸可能会降低术后阿片类药物的使用率,而不会对妊娠率和并发症发生率产生不利影响。

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