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Titre du document / Document title

Incidence of hematoma associated with ketorolac after TRAM flap breast reconstruction

Auteur(s) / Author(s)

SHARMA Sanjay (1) ; CHANG David W. (1) ; KOUTZ Cindy (1) ; EVANS Gregory R. D. (1) ; ROBB Geoffrey L. (1) ; LANGSTEIN Howard N. (1) ; KROLL Stephen S. (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Plastic Surgery at The University of Texas M. D. Anderson Cancer Center and the Division of Plastic Surgery, Baylor College of Medicine, ETATS-UNIS

Résumé / Abstract

Ketorolac is frequently used as an adjunct for postoperative pain relief, especially by anesthesiologists during the immediate postoperative period. It can be used alone as an analgesic but is more often used to potentiate the actions of narcotics such as morphine or meperidine in an attempt to reduce the total dose and side effects of those drugs. The manufacturer of ketorolac cautions against its use in patients who have a high risk of postoperative bleeding, for fear of increasing the risk of hematoma, but the risk in transverse rectus abdominis musculocutaneous (TRAM) flap patients has never been reported. In a study of 215 patients who had undergone TRAM flap breast reconstruction, it was determined that patients who received intravenous ketorolac (n = 65) as an adjunct to their treatment with morphine administered by use of a patient-controlled analgesia device required less morphine (mean cumulative dose, 1.39 mg/kg) than did patients who did not receive ketorolac (n = 150; mean cumulative dose, 1.75 mg/kg; p = 0.02). There was no increase in the incidence of hematoma in patients who were treated with ketorolac. The data presented in this study suggest that the use of intravenous ketorolac does reduce the need for narcotics administration in patients undergoing TRAM flap breast reconstruction, without significantly increasing the risk of hematoma.

Revue / Journal Title

Plastic and reconstructive surgery    ISSN  0032-1052 

Source / Source

2001, vol. 107, no2, pp. 352-355 (5 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1963) (Revue)

Mots-clés anglais / English Keywords

Reconstruction

;

Mammary gland

;

Musculocutaneous flap

;

Rectus abdominis muscle

;

Free flap

;

Hematoma

;

Postoperative

;

Incidence

;

Ketorolac

;

Analgesic

;

Non steroidal antiinflammatory agent

;

Antipyretic

;

Enzyme inhibitor

;

Prostaglandin-endoperoxide synthase

;

Toxicity

;

Treatment

;

Chemotherapy

;

Human

;

Oxidoreductases

;

Enzyme

;

Plastic surgery

;

Surgery

;

Mammary gland diseases

;

Mots-clés français / French Keywords

Reconstruction

;

Glande mammaire

;

Lambeau musculocutané

;

Muscle grand droit abdomen

;

Lambeau libre

;

Hématome

;

Postopératoire

;

Incidence

;

Kétorolac

;

Analgésique

;

Antiinflammatoire non stéroïde

;

Antipyrétique

;

Inhibiteur enzyme

;

Prostaglandin-endoperoxide synthase

;

Toxicité

;

Traitement

;

Chimiothérapie

;

Homme

;

Oxidoreductases

;

Enzyme

;

Chirurgie plastique

;

Chirurgie

;

Glande mammaire pathologie

;

Mots-clés espagnols / Spanish Keywords

Reconstrucción

;

Glándula mamaria

;

Colgajo musculocutáneo

;

Músculo recto mayor abdomen

;

Colgajo libre

;

Hematoma

;

Postoperatorio

;

Incidencia

;

Ketorolaco

;

Analgésico

;

Antiinflamatorio no esteroide

;

Antipirético

;

Inhibidor enzima

;

Prostaglandin-endoperoxide synthase

;

Toxicidad

;

Tratamiento

;

Quimioterapia

;

Hombre

;

Oxidoreductases

;

Enzima

;

Cirugía plástica

;

Cirugía

;

Glándula mamaria patología

;

Localisation / Location

INIST-CNRS, Cote INIST : 11075, 35400009864167.0080

Nº notice refdoc (ud4) : 885489



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