Scheduled intravenous ketorolac is safe and reduces narcotic use after robotic-assisted simple prostatectomy.

Autor: Ganesan V; Department of Urology, University of Texas Southwestern, Dallas, TX, USA. vxg116@case.edu.; Department of Urology, University of Minnesota, Minneapolis, USA. vxg116@case.edu., Steinberg RL; Department of Urology, University of Texas Southwestern, Dallas, TX, USA.; Department of Urology, University of Iowa, Iowa City, USA., Trivedi H; Department of Urology, University of Texas Southwestern, Dallas, TX, USA., Sorokin I; Department of Urology, University of Texas Southwestern, Dallas, TX, USA., Johnson BA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA., Gahan JC; Department of Urology, University of Texas Southwestern, Dallas, TX, USA.; Department of Urology, Duke, Durham, USA.
Jazyk: angličtina
Zdroj: Journal of robotic surgery [J Robot Surg] 2024 Oct 03; Vol. 18 (1), pp. 358. Date of Electronic Publication: 2024 Oct 03.
DOI: 10.1007/s11701-024-02068-5
Abstrakt: We sought to examine whether scheduled intravenous (IV) ketorolac decreased post-operative narcotic utilization and changed peri-operative outcomes (including complications) in patients undergoing robotic-assisted simple prostatectomy (RASP). An IRB-approved, retrospective chart review was performed of all patients undergoing RASP at a single institution from November 2017 to July 2019. Patient demographic, peri-operative, and post-operative data, including morphine equivalent use (MEU), were collected. Scheduled ketorolac use was implemented at the surgeon's discretion for up to 5 days post-operatively. The primary outcome was MEU in the post-operative stay. Two hundred seven men underwent RASP during the study period, of which 143 (69%) received scheduled ketorolac. No differences in patient demographics, prostate size, prior opioid utilization, or operative characteristics were identified between groups. Median MEU was significant less (5 vs 15, p < 0.001) in patients receiving scheduled ketorolac. Significantly more patients receiving scheduled ketorolac did not require the use of any narcotic during hospitalization (30% vs 11%, p = 0.005). On multivariable linear regression adjusted for age, BMI, prior opioid use, and length of stay, ketorolac use independently associated with decreased narcotic use (p = 0.003). No significant difference in transfusion rates were identified (3.5% vs. 1.6%, p = 0.44). Scheduled ketorolac is effective in reducing post-operative, in-hospital opioid utilization without increasing morbidity after RASP. Almost a third of patients on scheduled ketorolac did not require any opioids post-operatively.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
Externí odkaz: