الفهرس | Only 14 pages are availabe for public view |
Abstract NSAIDs effectively treat postoperative pain, leading to reductions in opioid use, time to first ambulation, and time to first bowel movement. Injectable NSAIDs, such as ketorolac, have been shown to have an equivalent analgesic effect to morphine in major abdominal surgery and reduce the use of opioid medications. The main aim of this study was to determine if ketorolac over use is associated with higher rates of reinterventions, emergency department (ED) visits, and readmissions. The study had been conducted on 50 adult patients who undergo colorectal surgery in general surgery department in Menoufia University and Damnhour medical national institute in the period from October 2018 to November 2020. Outcome of the study: The ketorolac group was associated with higher ED visits (k: 16% vs no K: 12%), higher rates of readmission (k: 12% vs no K: 8%), and equal rates of reintervention (k: 4% vs no K: 4%) with no statistically significant differences between patients with and without ketorolac. As regard rates of anastomotic leakage the ketorolac group was associated with higher rates of anastomotic leakage (k: 12% vs no K: 8%) during the postoperative period. Also rates of anastomotic leakage in relation to use of ketorolac during the postoperative period for the ketorolac group and it show that 1 (4%) used ketorolac for 3-5 days and 2(8%) used ketorolac more than 5 days; it shows statistically significant rates of anastomotic leakage with long use of ketorolac p value 0.009. As regard amount of post-operative bleeding in relation to use of ketorolac during the postoperative period for the studied group and it show that 3 (12%) used ketorolac for 1-2 days with mean blood loss 440.45±93.5 ml, 13 (52%) used ketorolac for 3- 5 days with mean blood loss 680.96±70.2 ml and 9 (36%) used ketorolac for more than 5 days with mean blood loss 850.46±70.5 ml. It shows statistically significant rates of post-operative bleeding with long use of ketorolac p value 0.001 Based on our findings, we recommend for further prospective studies on larger sample size and on large geographical scale to emphasize our conclusion. |