S H Wilson, H Slone, C M Furse, T I Epperson, B J Wolf
Purpose: The objective of this study was to examine postoperative opioid consumption in outpatients undergoing knee arthroscopy after a single dose of intravenous ketorolac.
Methods: Patients ages 18-65 years old, weighing over 50kg and scheduled for knee arthroscopy were randomized to one of the four groups of preoperative ketorolac (0mg, 7.5mg, 15mg, 30mg). The primary outcome measured was postoperative opioid consumption. Secondary outcomes included visual analog scale pain scores, patient satisfaction scores, side effects and total postoperative anesthesia care unit time. Equivalency between ketorolac groups in opioid reduction relative to placebo was evaluated for each dose pair (7.5 vs. 15mg, 7.5 vs. 30mg, and 15 vs. 30mg). Linear regression models were used to examine associations between ketorolac dose with postoperative length of stay and patient satisfaction. A linear mixed model was used to evalaute the association between ketorolac dose and pain scores over time.
Results: A total of 112 patients with comparable patient and procedural characteristics were enrolled. Equivalency in opioid reduction relative to placebo was not demonstrated between any examined ketorlac doses (7.5 vs. 15mg, P = 0.167; 7.5 vs. 30mg, P = 0.451; 15 vs. 30mg, P = 0.515). Compared to placebo, all ketorlac doses decreased postoperative pain scores (global P=0.012). Patient satisfaction and postoperative duration did not vary with ketorolac dose.
Conclusions: Although all ketorolac doses decreased PACU pain scores, equivalency in PACU opioid reduction between ketorolac doses was not demonstrated.
目的:本研究的目的是检查门诊患者在单剂量静脉注射酮罗拉酸后膝关节镜术后阿片类药物的消耗。方法:年龄18-65岁，体重大于50kg，拟行膝关节镜检查的患者随机分为术前使用酮罗拉酸(0mg, 7.5mg, 15mg, 30mg)四组。测量的主要结果是术后阿片类药物的消耗。次要结果包括视觉模拟量表疼痛评分、患者满意度评分、副作用和术后麻醉护理总单位时间。在每个剂量对(7.5 vs. 15mg, 7.5 vs. 30mg, 15 vs. 30mg)中，酮罗拉酸组相对于安慰剂在阿片类药物减少方面的等效性进行了评估。线性回归模型用于检验酮咯酸剂量与术后住院时间和患者满意度之间的关系。使用线性混合模型来评估酮咯酸剂量与疼痛评分之间随时间的关系。结果:共有112例具有相似患者和手术特征的患者入组。在任何检查的酮lac剂量之间，没有证明阿片类药物减少相对于安慰剂的等效性(7.5 vs 15mg, P = 0.167;7.5 vs 30mg, P = 0.451;15 vs 30mg, P = 0.515)。与安慰剂相比，所有酮lac剂量均降低了术后疼痛评分(总体P=0.012)。患者满意度和术后持续时间不随酮咯酸剂量而变化。结论:虽然所有酮罗拉酸剂量都降低了PACU疼痛评分，但酮罗拉酸剂量之间在PACU阿片类药物减少方面的等效性并未得到证实。
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