Renal Safety of Intravenous Ketorolac Use After Donor Nephrectomy
| Autor: | Parissa Tabrizian, Edward H. Chin, Benjamin Tran, Ron Shapiro, Michael Palese, Daniel M. Herron, Jake G. Prigoff, Matthew L. Holzner, Dianne LaPointe Rudow, Massimo Giacca, Sander Florman, Antonios Arvelakis |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Operative Time Postoperative Hemorrhage 030204 cardiovascular system & hematology Nephrectomy 03 medical and health sciences Postoperative Complications 0302 clinical medicine 030202 anesthesiology Living Donors medicine Humans In patient Renal Insufficiency Warm Ischemia Retrospective Studies Pain Postoperative Transplantation business.industry Anti-Inflammatory Agents Non-Steroidal Length of Stay Middle Aged Surgical procedures Surgery Ketorolac Creatinine Administration Intravenous Female Laparoscopy business medicine.drug |
| Zdroj: | Progress in Transplantation. 29:283-286 |
| ISSN: | 2164-6708 1526-9248 |
| DOI: | 10.1177/1526924819855360 |
| Popis: | Introduction: The benefit and short-term safety of ketorolac have been established in previous studies however, the risk of bleeding and long-term renal impairment in patients undergoing donor nephrectomy remain unclear. We report our experience at a high-volume transplant center. Method: Between January 1996 and January 2014, 862 consecutive patients underwent laparoscopic donor nephrectomy. Exclusion criteria included nonsteroidal anti-inflammatory drug allergy, asthma, bleeding disorders, long-term opioid use, intraoperative blood loss >700 mL, peptic ulcer disease, bleeding diathesis, and baseline creatinine greater than 1.9 mg/dL. Intravenous ketorolac was administered within 30 minutes following the surgical procedure at a dose of 15 to 30 mg every 6 hours. Patients were categorized into 2 groups according to the administration of ketorolac after surgery. Differences between the groups were analyzed. Primary outcomes were changes in serum creatinine and hemoglobin levels. Poor outcome was defined as postsurgical complications. Results: During this time, 469 (55.3%) received ketorolac. The mean donor age was 39 years, and 360 (42.5%) were male. Left kidneys were procured in 82%. Operative time averaged 210 minutes and warm ischemia time117 seconds. Baseline demographic and operative outcomes were comparable in both groups. No statistically significant differences were found between the ketorolac group and the nonketorolac group in preoperative and postoperative hemoglobin levels and serum creatinine at 1 week, 1 year, and 5 years ( P = .6). Ketorolac use was not associated with increased perioperative morbidity ( P = NS). Conclusion: The use of intravenous ketorolac in patients undergoing donor nephrectomy was not associated with an increased risk of bleeding or renal impairment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|