Abstract
Purpose
To assess the postoperative analgesic efficacy and morphine-sparing effect of ketorolac in elderly patients.
Methods
Sixty ASA-physical status I to III men, aged 60–88 yr, undergoing transvesical prostatectomy were studied according to a randomized, placebo controlled, double-blind study protocol. A standard general anaesthetic was administered. Thirty minutes before concluding the surgical procedure either ketorolac 60 mg or an equal volume of saline was administered, im. Postoperative pain was assessed hourly for six hours using a 100 mm visual analog score (VAS) and a patient-controlled analgesia (PCA) device.
Results
Hourly PCA-demands, actual morphine delivered, and patient generated VAS pain scores were unaffected by the treatment modality. On conclusion of the study the total PCA morphine delivered was 11.9 mg ± 1.38 and 10.8 mg ± 1.52 for the saline and ketorolac groups, respectively.
Conclusion
The intraoperative administration of ketorolac, 60 mg, im, was not associated with postoperative morphinesparing or improved analgesia in this elderly population.
Résumé
Objectif
Evaluer l’efficacité analgésique postopératoire et l’effet d’épargne du kétorolac sur la morphine chez les patients âgés.
Méthodes
Soixante patients du sexe masculin ASA I à III âgés de 60 à 88 ans, soumis à une prostatectomie transvésicale ont fait l’objet d’une étude aléatoire, contrôlée avec placebo et en double aveugle. Une anesthésie générale standardisée a été administrée. Trente minutes avant la fin de l’intervention, du kétorolac 60 mg ou une volume égal de soluté physiologique ont été administré i.m. La douleur postopératoire a été évaluée à toutes les heures pour six heures sur une échelle visuelle analogique de 100 mm (EVA) et à l’aide d’un dispositif d’analgésie autocontrôlée (PCA).
Résultais
La demande horaire sur PCA. la quantité de morphine administrée et le score sur l’EVA fourni par le patient n’ont pas été affectés par le mode de traitement. A la fin de l’étude, la morphine totale administrée était de 11,9 mg ± 1,38 et de 10,8 mg ± 1,52 respectivement pour le groupe soluté physiologique et pour le groupe kétorolac.
Conclusion
L’administration peropératoire de kélorolac 60 mg im n’est pas associée à un effet d’épargne sur la morphine ou à une amélioration de l’analgésie chez ces patients âgés.
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Fredman, B., Olsfanger, D., Flor, P. et al. Ketorolac does not decrease postoperative pain in elderly men after transvesical prostatectomy. Can J Anesth 43, 438–441 (1996). https://doi.org/10.1007/BF03018103
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DOI: https://doi.org/10.1007/BF03018103