Document Detail

The effects of ketorolac and fentanyl on postoperative vomiting and analgesic requirements in children undergoing strabismus surgery.
MedLine Citation:
PMID:  7762839     Owner:  NLM     Status:  MEDLINE    
Fifty-four ASA I and II children 1 to 10 yr of age undergoing strabismus surgery were randomized to receive in a double-blind fashion intravenous ketorolac (0.9 mg/kg), fentanyl (1 microgram/kg), or saline placebo (2 mL) during a standardized general anesthetic. Patients received no analgesic or antiemetics intraoperatively except for the study drug. Patients receiving ketorolac or placebo compared to fentanyl had a significantly lower incidence of postoperative vomiting in the day surgery unit (DSU) (P = 0.03) and overall (DSU plus home) (P = 0.005). The severity (number of episodes) of post-operative vomiting was significantly lower in the DSU, at home (first 24 h after hospital discharge), and overall for patients receiving ketorolac or placebo compared to fentanyl (P < 0.01). Postoperative pain scores and frequency of acetaminophen administration did not differ among the study groups, suggesting that the intraoperative use of ketorolac or fentanyl during pediatric strabismus surgery is unnecessary. No patients required fentanyl postoperatively, indicating that rectal acetaminophen administered in the postanesthesia recovery room provides sufficient analgesia for pediatric strabismus surgery. In conclusion, neither ketorolac nor fentanyl was associated with less postoperative vomiting or analgesic requirements compared to saline placebo administered during pediatric strabismus surgery. Fentanyl should be avoided, as it was associated with a significantly greater incidence of postoperative vomiting compared to ketorolac or placebo.
H G Mendel; K M Guarnieri; L M Sundt; M C Torjman
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  80     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1995 Jun 
Date Detail:
Created Date:  1995-06-27     Completed Date:  1995-06-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1129-33     Citation Subset:  AIM; IM    
Department of Anesthesiology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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MeSH Terms
Acetaminophen / therapeutic use
Ambulatory Surgical Procedures
Analgesics, Non-Narcotic* / adverse effects
Anesthesia* / adverse effects
Child, Preschool
Double-Blind Method
Fentanyl* / adverse effects
Pain, Postoperative / drug therapy*
Postoperative Complications*
Strabismus / surgery*
Tolmetin / adverse effects,  analogs & derivatives*
Vomiting / chemically induced,  drug therapy,  etiology*
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 103-90-2/Acetaminophen; 26171-23-3/Tolmetin; 437-38-7/Fentanyl; 66635-83-4/Ketorolac
Comment In:
Anesth Analg. 1996 Apr;82(4):889-90   [PMID:  8615527 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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