|The effects of ketorolac on microvascular thrombosis in lower extremity reconstruction.|
|PMID: 22327889 Owner: NLM Status: MEDLINE|
|BACKGROUND: Ketorolac is commonly prescribed for relieving postoperative pain and is known to have an anticoagulation effect, though this has not been studied in a clinical series. The aim of this study was to evaluate the effects of ketorolac on microvascular thrombosis in lower extremity reconstruction.
METHODS: A retrospective chart review was performed for patients who underwent lower limb reconstruction with a free flap between January of 2005 and September of 2011. Patients were categorized into two groups based on the administration of ketorolac for postoperative pain relief. Complications were assessed, and the two groups were compared for vascular insufficiency, total or partial flap loss, and hematoma formation.
RESULTS: A total of 128 patients underwent microsurgical flap transfer, including 111 thoracodorsal artery perforator flaps, four latissimus dorsi myocutaneous flaps, seven deep inferior epigastric artery perforator flaps, and six anterolateral thigh flaps. Eighty patients were administrated ketorolac, and 48 patients were not. The nonketorolac group had significantly higher rates of vascular-related complications, and the difference remained significant after adjusting for confounding factors on multivariate logistic regression analysis. There was a correlation between the duration of ketorolac administration and complication rates, for which longer periods of ketorolac administration yielded lower complication rates.
CONCLUSION: Ketorolac administration has a protective effect against the development of microvascular thrombosis and can be a preferred analgesic in free tissue transfer.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
|Kyeong Tae Lee; Byung-Joon Jeon; So-Young Lim; Jai-Kyung Pyon; Sa-Ik Bang; Kap-Sung Oh; Goo-Hyun Mun|
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|Type: Comparative Study; Journal Article|
|Title: Plastic and reconstructive surgery Volume: 129 ISSN: 1529-4242 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 2012 Jun|
|Created Date: 2012-05-30 Completed Date: 2012-08-07 Revised Date: 2012-11-27|
Medline Journal Info:
|Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: United States|
|Languages: eng Pagination: 1322-7 Citation Subset: AIM; IM|
|Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.|
|APA/MLA Format Download EndNote Download BibTex|
Aged, 80 and over
Cyclooxygenase Inhibitors / administration & dosage
Free Tissue Flaps*
Ketorolac / administration & dosage*
Lower Extremity / blood supply, surgery*
Microcirculation / drug effects*
Microsurgery / adverse effects
Pain, Postoperative / diagnosis, drug therapy
Postoperative Care / methods*
Reconstructive Surgical Procedures / adverse effects*
Thrombosis / drug therapy*, etiology
|0/Cyclooxygenase Inhibitors; 66635-83-4/Ketorolac|
|Plast Reconstr Surg. 2012 Oct;130(4):618e-619e; author reply 619e-620e
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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