Erstad B L, Rappaport W D
Department of Pharmacy Practice, College of Pharmacy, University of Arizona, Tucson 85721.
Pharmacotherapy. 1994 Sep-Oct;14(5):613-5.
Ketorolac is the first injectable nonsteroidal antiinflammatory drug used as an analgesic in the perioperative period. Its adverse effect profile is different from that of the opioid analgesics; in particular, in its lack of respiratory depressive actions. However, ketorolac has risks associated with its perioperative administration, including episodes of substantial gastrointestinal bleeding. A patient undergoing elective laparoscopic cholecystectomy developed a subcapsular hepatic hematoma shortly after receiving a dose of injectable ketorolac. No evidence of parenchymal injury was found on laparoscopy, which argues against iatrogenic trauma. Clinicians should be aware that ketorolac may cause or aggravate bleeding, and it should be used with caution in perioperative patients.
酮咯酸是第一种在围手术期用作镇痛药的注射用非甾体抗炎药。其不良反应谱与阿片类镇痛药不同；特别是，它没有呼吸抑制作用。然而，酮咯酸围手术期给药存在风险，包括严重胃肠道出血事件。一名接受择期腹腔镜胆囊切除术的患者在接受一剂注射用酮咯酸后不久出现肝包膜下血肿。腹腔镜检查未发现实质损伤的证据，这排除了医源性创伤。临床医生应意识到酮咯酸可能导致或加重出血，在围手术期患者中应谨慎使用。
