Opioid-sparing Effects of Ketorolac and Its Correlation With the Recovery of Postoperative Bowel Function in Colorectal Surgery Patients
- 1 July 2009
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in The Clinical Journal of Pain
- Vol. 25 (6), 485-489
- https://doi.org/10.1097/ajp.0b013e31819a506b
Abstract
Postoperative ileus (PI) is one of many common complications in major abdominal surgery. PI results in patient discomfort, increased gastrointestinal leakage, prolonged hospital stay, and increased medical expenses. In this study, we have investigated the morphine-sparing effects of ketorolac and its correlation with the duration of PI in patients with colorectal surgeries.We collected data from 102 patients who had received elective colorectal resection. The patients were randomly allocated into 2 groups and received intravenous patient-controlled analgesia (IVPCA) morphine (M group) or IVPCA morphine plus ketorolac (M+K group). Time-scale morphine consumption (per 12 h), recovery of bowel functions (the first bowel movement and passage of flatus), pain scores, and opioid-related side effects were then recorded.Patients in the M+K group received 18.3% less morphine than those in the M group within 72 postoperative hours. The maximal opioid-sparing effects of ketorolac appeared in 12 to 24 postoperative hours. The onset of the first bowel movement and passage of flatus was significantly less in the M+K group than in the M group. The M group showed a 5.25 times greater risk of inducing PI, a result comparable with the M+K group in colorectal surgery patients.The addition of ketorolac to IVPCA morphine has demonstrated a clear opioid-sparing effect and benefits in regards to the shortening of the duration of bowel immobility. We suggest that adding ketorolac to morphine IVPCA be included in the multimodal postoperative rehabilitation program for the early restoration of normal bowel function.Keywords
This publication has 24 references indexed in Scilit:
- Differential Sensitization of Afferent Neuronal Pathways During Postoperative Ileus in the Mouse JejunumAnnals of Surgery, 2008
- Current strategies for preventing or ameliorating postoperative ileus: A multimodal approachAmerican Journal of Health-System Pharmacy, 2007
- Pathogenesis and clinical and economic consequences of postoperative ileusAmerican Journal of Health-System Pharmacy, 2007
- Altered inflammatory gene expression underlies increased susceptibility to murine postoperative ileus with advancing ageAmerican Journal of Physiology-Gastrointestinal and Liver Physiology, 2007
- Intestinal handling-induced mast cell activation and inflammation in human postoperative ileusGut, 2007
- Inhibition of macrophage function prevents intestinal inflammation and postoperative ileus in rodentsGut, 2007
- Epidural hematoma after thoracic epidural catheter removal in the absence of risk factorsRegional Anesthesia & Pain Medicine, 2003
- Epidural Hematoma After Thoracic Epidural Catheter Removal in the Absence of Risk FactorsRegional Anesthesia & Pain Medicine, 2003
- Postoperative IleusDrugs, 2002
- The effect of intraoperative thoracic epidural anesthesia and postoperative analgesia on bowel function after colorectal surgeryDiseases of the Colon & Rectum, 2001