Dordoni P L, Della Ventura M, Stefanelli A, Iannace E, Paparella P, Rocca B, Accorra F
Department of Anesthesiology and Resuscitation, Catholic University School of Medicine, Rome, Italy.
Anaesthesia. 1994 Dec;49(12):1046-9. doi: 10.1111/j.1365-2044.1994.tb04352.x.
Ketorolac, ketoprofen and nefopam are often used in the treatment of postoperative pain. While nefopam is a non-narcotic, non-opioid central analgesic agent, ketorolac and ketoprofen are non-steroidal anti-inflammatory drugs, which, due to their prostaglandin-synthetase inhibiting activity, have antiplatelet effects. In this study we investigated the effect of ketorolac, ketoprofen and nefopam on platelet function by performing bleeding time and in vitro platelet aggregation in 30 healthy volunteers (10 for each treatment) before and 3 h after drug administration. Nefopam did not affect bleeding time and platelet aggregation, while ketorolac and ketoprofen significantly prolonged bleeding time without significantly inhibiting platelet aggregation in response to adenosine diphosphate. The prolongation of bleeding time observed after ketorolac and ketoprofen may have clinical relevance and suggests that nefopam could be more safely administered for the treatment of postoperative pain, especially in patients with haemostatic defects or after high bleeding risk surgery.
酮咯酸、酮洛芬和奈福泮常用于治疗术后疼痛。奈福泮是一种非麻醉性、非阿片类中枢镇痛药，而酮咯酸和酮洛芬是非甾体抗炎药，由于它们具有抑制前列腺素合成酶的活性，因而具有抗血小板作用。在本研究中，我们通过对30名健康志愿者（每种治疗10人）在给药前和给药后3小时进行出血时间测定和体外血小板聚集试验，研究了酮咯酸、酮洛芬和奈福泮对血小板功能的影响。奈福泮不影响出血时间和血小板聚集，而酮咯酸和酮洛芬显著延长出血时间，但对二磷酸腺苷诱导的血小板聚集无明显抑制作用。酮咯酸和酮洛芬给药后观察到的出血时间延长可能具有临床意义，这表明奈福泮用于治疗术后疼痛可能更安全，尤其是对于有止血缺陷的患者或高出血风险手术后的患者。
