Document Detail


The effects of ketorolac on microvascular thrombosis in lower extremity reconstruction.
MedLine Citation:
PMID:  22327889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  129     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2012 Jun 
Date Detail:
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    
Other Details:
Languages:  eng     Pagination:  1322-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Cyclooxygenase Inhibitors / administration & dosage
Female
Follow-Up Studies
Free Tissue Flaps*
Humans
Injections, Intravenous
Ketorolac / administration & dosage*
Lower Extremity / blood supply,  surgery*
Male
Microcirculation / drug effects*
Microsurgery / adverse effects
Middle Aged
Pain Measurement
Pain, Postoperative / diagnosis,  drug therapy
Postoperative Care / methods*
Reconstructive Surgical Procedures / adverse effects*
Retrospective Studies
Thrombosis / drug therapy*,  etiology
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Cyclooxygenase Inhibitors; 66635-83-4/Ketorolac
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2012 Oct;130(4):618e-619e; author reply 619e-620e   [PMID:  23018729 ]

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


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