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Anesthesia and analgesia in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Ketorolac is a nonsteroidal anti-inflammatory agent that has good analgesic efficacy for various types of painful conditions. It is attractive in that it causes no sedation and no respiratory depression (39). There are concerns about its use in obstetrics in that it may decrease uterine contractions and/or close the fetal ductus arteriosus. In one study comparing the analgesic effect of ketorolac with meperidine, ketorolac was not found to be superior (40). Another study demonstrated potential adverse effects on neonatal platelet function (41). At present, there appears to be no benefit from the use of ketorolac for labor analgesia.
Drugs Affecting the Musculoskeletal System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: It is better to be avoided during the 1st and 3rd Trimesters because the pregnancy experience in humans suggests a risk of pulmonary hypertension of the newborn, SABs, and congenital malformations linked to the use of Ketorolac.
Nephrolithiasis: surgical treatment and metabolic evaluation
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Pain control: NarcoticsNSAIDs: may consider ketorolac if no history of renal disease, bleeding diathesis, peptic ulcer disease, or gastroesophageal reflux disease.
Ligasure™ Impact and Ligasure™ Small Jaw in Body Contouring after Massive Weight Loss: A New Perspective
Published in Journal of Investigative Surgery, 2022
Diletta Maria Pierazzi, Edoardo Pica Alfieri, Roberto Cuomo, Maria Alessandra Bocchiotti, Luca Grimaldi, Aniello Donniacuo, Irene Zerini, Giuseppe Nisi
Postoperative care was the same in each procedure. It was characterized by thromboprophylaxis with subcutaneous low-molecular-weight heparin, antithrombotic stockings and early mobilization. Subjective pain was evaluated using VAS scale every 4 hours during the first 36 hours after surgery: each time VAS value was superior to 3 was recorded and analyzed in the study. Postoperative pain was always managed through 1000 mg of intravenous paracetamol 6 hours and 12 hours after surgery; additional pain was treated on demand with 30 mg of intravenous ketorolac. Each intravenous dose of ketorolac in the first 36 hours after the operation was recorded as “additional analgesic” and evaluated in this study. Drains were removed when drainage amount was less than 50 cc/day in abdominoplasty and mastopexy, and less than 20 cc/day in brachioplasty and medial thigh lift.
Pharmacokinetics and efficacy of a ketorolac-loaded ocular coil in New Zealand white rabbits
Published in Drug Delivery, 2021
Christian J. F. Bertens, Marlies Gijs, Aylvin A. J. Dias, Frank J. H. M. van den Biggelaar, Arkasubhra Ghosh, Swaminathan Sethu, Rudy M. M. A. Nuijts
The technical details and in vitro release kinetics have been previously described (Bertens et al., 2020). Briefly, ocular coils (16 mm long, wire thickness of 0.084 mm with an outer diameter of 0.90 mm) were ordered from EPflex (Dettingen an der Erms, DE). The ocular coils were manually filled with 3 mg ketorolac entrapped poly-methyl methacrylate (PMMA, Mn ≈ 43 kg/mol) microspheres (26.5 wt% drug loading) 150 µm ± 10 µm in diameter. Hereafter, the ocular coil was closed on both extremities with a dome-shaped UV-curable acrylate urethane cap to soften its extremities while maintaining the drug-eluting matrix inside. The in vitro release kinetic study showed that a total of 69.9 ± 5.6% (0.795 ± 0.063 mg ketorolac) of the loaded ketorolac was released in 28 days. In the first 3 days, a high (burst) release of approximately 50% of ketorolac was observed followed by a more gradual release up to 28 days.
Effect of bilateral ultrasound-guided erector spinae blocks on postoperative pain and opioid use after lumbar spine surgery: A prospective randomized controlled trial
Published in Egyptian Journal of Anaesthesia, 2021
Amr Samir Wahdan, Tarek Ahmed Radwan, Mostafa Mahmoud Mohammed, Ahmed Abdalla Mohamed, Atef Kamel Salama
In both groups, the same postoperative analgesic protocol was prescribed: 30 min prior to the end of the procedure, 30 mg of IV ketorolac was administered and repeated every 8 h postoperatively. IV morphine was given when subjects requested a postoperative pain control agent in a loading dose of 0.05 mg/kg. Afterward, the patients were connected to a disposable silicon PCA infusion device (M5015L Accufuser 300 mL) containing 30 mg of morphine. The PCA was programmed to provide 5 mL/h (0.5 mg morphine per hour) by continuous infusion and 1 mL bolus dose (0.1 mg morphine per dose) whenever needed, with a lockout interval of 15 min. Additional IV bolus doses of morphine were given as a rescue analgesic dose for patients who had a VAS score≥4 or when experiencing pain between the assessment intervals. A dose of 0.15 mg/kg of IV metoclopramide was designated to patients suffering from nausea or vomiting.