Buckley R C, Davidson S F, Das S K
Department of Surgery, University of Mississippi Medical Center, Jackson.
Br J Plast Surg. 1993 Jun;46(4):296-9. doi: 10.1016/0007-1226(93)90006-w.
Ketorolac tromethamine (Toradol), a potent nonsteroidal anti-inflammatory drug used for postoperative pain, also strongly inhibits platelet aggregation. The anti-thrombotic effects of intramuscular ketorolac were assessed with a described rat model of microarterial thrombosis. After a single dose of ketorolac mean bleeding times were significantly prolonged (p < 0.01) and platelet aggregation was markedly reduced. Patency rates at 20 min were significantly higher in ketorolac groups compared to controls (p < 0.005). However, all vessels were thrombosed at 24 h. Scanning electron microscopy demonstrated decreased platelet aggregation and decreased thrombus formation in ketorolac treated animals at 20 min. The prolonged bleeding time and reduction in platelet aggregation add support to concerns of bleeding complications reported in patients treated with ketorolac perioperatively. Thus, ketorolac should probably not be used for pain relief in patients in whom postoperative haematoma formation is a particular concern. In addition, in this model, ketorolac as a single agent was ineffective for long-term prevention of microarterial thrombosis.
酮咯酸氨丁三醇（痛力克）是一种用于术后疼痛的强效非甾体抗炎药，它也能强烈抑制血小板聚集。采用一种已描述的大鼠微动脉血栓形成模型评估了肌肉注射酮咯酸的抗血栓作用。单次给予酮咯酸后，平均出血时间显著延长（p < 0.01），血小板聚集明显减少。与对照组相比，酮咯酸组在20分钟时的血管通畅率显著更高（p < 0.005）。然而，所有血管在24小时时均形成血栓。扫描电子显微镜显示，在20分钟时，接受酮咯酸治疗的动物血小板聚集减少，血栓形成减少。出血时间延长和血小板聚集减少进一步支持了关于围手术期接受酮咯酸治疗的患者出血并发症的担忧。因此，对于术后血肿形成是特别需要关注问题的患者，可能不应使用酮咯酸来缓解疼痛。此外，在该模型中，酮咯酸作为单一药物对微动脉血栓形成的长期预防无效。
