Camu F, Lauwers M H, Vanlersberghe C
Department of Anesthesiology, Flemish Free University of Brussels School of Medicine, Belgium.
Acta Anaesthesiol Belg. 1996;47(3):143-9.
We reviewed the pathogenesis of the most important side effects of non-steroidal antiinflammatory drugs (NSAIDs). Short-term treatments for postoperative pain are not generally associated with gastric damage. Pharmacoepidemiological studies have shown that for ketorolac the risk of gastrointestinal bleeding was only important in older patients and when doses > 90 mg/day were used. Although NSAIDs cause platelet dysfunction resulting in prolonged bleeding time, these drugs do not affect clot formation. Therefore, NSAIDs should be used with caution in surgical procedures involving considerable dissection of tissues and where any reduction in hemostatic function could be hazardous. Acute reversible renal dysfunction may occur when volume depletion or reduced renal function are present, in particular in elderly patients. NSAIDs should also be used with great caution in asthmatic patients. In general, the adverse events associated with ketorolac are similar to other NSAIDs. Provided the current European Community label prescription of ketorolac is not exceeded and with due observation of the contra-indications for use of NSAIDs, this agent is not likely to induce an increased risk of adverse events.
我们回顾了非甾体抗炎药（NSAIDs）最重要的副作用的发病机制。术后疼痛的短期治疗一般与胃损伤无关。药物流行病学研究表明，对于酮咯酸，胃肠道出血风险仅在老年患者以及使用剂量>90mg/天时才较为显著。尽管NSAIDs会导致血小板功能障碍，使出血时间延长，但这些药物并不影响血凝块形成。因此，在涉及大量组织解剖且任何止血功能降低都可能有危险的外科手术中，应谨慎使用NSAIDs。当存在血容量不足或肾功能减退时，尤其是老年患者，可能会发生急性可逆性肾功能障碍。NSAIDs在哮喘患者中也应极其谨慎使用。一般来说，与酮咯酸相关的不良事件与其他NSAIDs相似。只要不超过目前欧洲共同体对酮咯酸的标签规定剂量，并适当遵守NSAIDs使用的禁忌症，该药物不太可能增加不良事件的风险。
