Cade L, Kakulas P
Royal Women's Hospital, Melbourne, Victoria.
Anaesth Intensive Care. 1995 Apr;23(2):158-61. doi: 10.1177/0310057X9502300205.
Laparoscopic sterilization is commonly performed as a day surgery procedure despite difficulties in providing adequate postoperative analgesia for all patients. We have examined the analgesic utility of intramuscular ketorolac in this setting by comparing it with intramuscular pethidine, both given after induction in a randomized, double-blind study in sixty such patients. Although the analgesic effects of the two drugs were comparable in the immediate postoperative period, ketorolac provided significantly better analgesia four hours after surgery (pain score of 2.7 v. 4.2, P = 0.006). The recovery times taken to awake, to ambulate and for discharge were all significantly shorter after ketorolac (4.6 v. 8.8 min, P = 0.01; 178 v. 260 min, P = 0.0005; 242 v. 320 min, P = 0.02), and the unplanned admission rate was also significantly less after ketorolac (7% v. 33%, P = 0.01). Ketorolac appears to be a useful supplement for analgesia after laparoscopic sterilization, providing improved analgesia as well as decreased recovery time and fewer unplanned admissions.
尽管为所有患者提供充分的术后镇痛存在困难，但腹腔镜绝育术通常作为日间手术进行。在一项针对60例此类患者的随机双盲研究中，我们通过将肌肉注射酮咯酸与肌肉注射哌替啶进行比较，研究了酮咯酸在这种情况下的镇痛效果。虽然两种药物在术后即刻的镇痛效果相当，但酮咯酸在术后4小时提供了明显更好的镇痛效果（疼痛评分2.7对4.2，P = 0.006）。使用酮咯酸后，苏醒时间、下床活动时间和出院时间均显著缩短（4.6对8.8分钟，P = 0.01；178对260分钟，P = 0.0005；242对320分钟，P = 0.02），且酮咯酸组的非计划住院率也显著降低（7%对33%，P = 0.01）。酮咯酸似乎是腹腔镜绝育术后镇痛的一种有用补充药物，它能提供更好的镇痛效果，同时减少恢复时间和非计划住院情况。
