Effect of timing of ketorolac administration on patient-controlled opioid use.

Abstract:

:In order to investigate the analgesic effect of timing of administration of ketorolac 10 mg i.v., we recorded patient-controlled use of diamorphine at 2, 4 and 12 h after abdominal hysterectomy. In a randomized, double-blind trial, 30 patients received ketorolac before skin incision and 28 after skin closure. A control group of 32 patients did not receive ketorolac. We measured operative blood loss and assessed nausea, vomiting and pruritus. After 2 h of patient-controlled analgesia, the median cumulative diamorphine dose in the group given ketorolac before operation was less than that of the control group (95% confidence interval 8-66 micrograms kg-1; P = 0.01). There were no other statistically significant differences in diamorphine consumption between the groups. The frequency of nausea and vomiting was similar in all groups Median blood loss in the group given ketorolac before operation exceeded that of the patients who did not receive ketorolac before operation (95% confidence interval 20-149 ml; P = 0.01). We conclude that the diamorphine-sparing effect of ketorolac attributable to timing of administration was small, conferred no clinical benefit and was accompanied by increased bleeding. No patient given ketorolac complained of pruritus.

journal_name

Br J Anaesth

authors

Rogers JE,Fleming BG,Macintosh KC,Johnston B,Morgan-Hughes JO

doi

10.1093/bja/75.1.15

subject

Has Abstract

pub_date

1995-07-01 00:00:00

pages

15-8

issue

1

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)41811-3

journal_volume

75

pub_type

临床试验,杂志文章,随机对照试验
  • Cardiovascular effects of propofol in the anaesthetized dog.

    abstract::This study was designed to investigate if propofol produced cardiovascular effects by direct actions or by indirect actions secondary to depression of the central nervous system. Experiments were performed on chloralose anaesthetized dogs in which all neurogenic cardiovascular reflexes were abolished by bilateral vago...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/63.1.87

    authors: Goodchild CS,Serrao JM

    更新日期:1989-07-01 00:00:00

  • Hypotension during induction of anaesthesia is neither a reliable nor a useful quality measure for comparison of anaesthetists' performance.

    abstract:Background:Identification of statistically reliable outcomes for comparison among anaesthetists is challenging. Time-weighted intraoperative mean arterial pressure <65 mm Hg (AUC 65 ) is associated with increased odds for myocardial damage. We explored retrospectively whether such hypotension before incision was statis...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aex153

    authors: Epstein RH,Dexter F,Schwenk ES

    更新日期:2017-07-01 00:00:00

  • Difficult arterial cannulation in children: is a near-infrared vascular imaging system the answer?

    abstract:BACKGROUND:Arterial cannulation is a common anaesthetic procedure that can be challenging and time-consuming in small children. By visualizing the position of the radial artery, near-infrared vascular imaging systems (NIRVISs) might be of assistance in arterial cannulation. The present study evaluates the effectiveness...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aes193

    authors: Cuper NJ,de Graaff JC,Hartman BJ,Verdaasdonk RM,Kalkman CJ

    更新日期:2012-09-01 00:00:00

  • Dose requirements of propofol by infusion during nitrous oxide anaesthesia in man. I: Patients premedicated with morphine sulphate.

    abstract::The study was performed to determine the ED50 and ED95 of a continuous infusion of the emulsion formulation of propofol during 67% nitrous oxide anaesthesia in 57 patients premedicated with morphine sulphate 0.15 mg kg-1. Anaesthesia was induced with propofol 2 mg kg-1, and maintained before incision with a fixed-rate...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/58.10.1080

    authors: Spelina KR,Coates DP,Monk CR,Prys-Roberts C,Norley I,Turtle MJ

    更新日期:1986-10-01 00:00:00

  • Neuromuscular and cardiovascular effects of mivacurium chloride (BW B1090U) during nitrous oxide-fentanyl-thiopentone and nitrous oxide-halothane anaesthesia.

    abstract::Seventy-two adult surgical patients were studied to compare neuromuscular and cardiovascular effects of mivacurium chloride during nitrous oxide-fentanyl-thiopentone (BAL group) or nitrous oxide-halothane (HAL group) anaesthesia. Eighteen patients in the BAL group received an initial bolus of mivacurium, either the ED...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章

    doi:10.1093/bja/64.2.193

    authors: From RP,Pearson KS,Choi WW,Abou-Donia M,Sokoll MD

    更新日期:1990-02-01 00:00:00

  • Dose-dependent prophylactic effect of nicorandil, an ATP-sensitive potassium channel opener, on intra-operative myocardial ischaemia in patients undergoing major abdominal surgery.

    abstract::Nicorandil, a nicotinamide nitrate derivative, relaxes vascular smooth muscle and reduces cardiac muscle contractility by increasing membrane potassium conductance, probably by activating ATP-sensitive potassium channels. In this prospective, randomized, double-blind, placebo-controlled clinical study, we examined the...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/86.3.332

    authors: Kaneko T,Saito Y,Hikawa Y,Yasuda K,Makita K

    更新日期:2001-03-01 00:00:00

  • Perioperative plasma endothelin-1 concentrations and vasoconstriction during prolonged plastic surgical procedures.

    abstract::The role of endothelin-1, a potent vasoconstrictor released by vascular endothelium, in the vasoconstriction that develops after prolonged operations is not clear. This study was performed in order to determine if there was any relationship between endothelin-1 and the degree of vasoconstriction during prolonged plast...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/74.6.661

    authors: Tuominen HP,Svartling NE,Tikkanen IT,Saijonmaa O,Asko-Seljavaara S

    更新日期:1995-06-01 00:00:00

  • The skeletal muscle response to edrophonium during neuromuscular blockade by tubocurarine in anaesthetized man.

    abstract::Tetanic contractions of the adductor pollicis muscle in man were evaluated continuously after the administration of tubocurarine 0.2 mg/kg and during reversal by edrophonium 0.1 mg/kg. Single twitch contractions of the adductor pollicis were measured simultaneously. The response of tetanic and single twitch contractio...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章

    doi:10.1093/bja/47.10.1087

    authors: Sugai N,Payne JP

    更新日期:1975-10-01 00:00:00

  • Effects of dexmedetomidine on adrenocortical function, and the cardiovascular, endocrine and inflammatory responses in post-operative patients needing sedation in the intensive care unit.

    abstract::We have compared the effects of dexmedetomidine and propofol on endocrine, metabolic, inflammatory and cardiovascular responses in patients in the intensive care unit (ICU) after major surgery. Twenty patients who were expected to require 8 h of post-operative sedation and ventilation were allocated randomly to receiv...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/86.5.650

    authors: Venn RM,Bryant A,Hall GM,Grounds RM

    更新日期:2001-05-01 00:00:00

  • Prevalence of ischaemic heart disease at admission to intensive care and its influence on red cell transfusion thresholds: multicentre Scottish Study.

    abstract:BACKGROUND:Restrictive transfusion triggers are safe for most critically ill patients, but doubts exist for patients with ischaemic heart disease (IHD). We investigated the prevalence of reported IHD at admission to the intensive care unit (ICU) and investigated how this influenced red cell transfusion triggers. We als...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,多中心研究

    doi:10.1093/bja/aei073

    authors: Walsh TS,McClelland DB,Lee RJ,Garrioch M,Maciver CR,McArdle F,Crofts SL,Mellor I,ATICS Study Group.

    更新日期:2005-04-01 00:00:00

  • Determination of residual antiplatelet activity of clopidogrel before neuraxial injections.

    abstract:BACKGROUND:Guidelines recommend discontinuation of clopidogrel for 7 days before a neuraxial injection, while other directives suggest that 5 days might be adequate. We examined the time course of antiplatelet activity after clopidogrel discontinuation in patients undergoing epidural injections. METHODS:Thirteen patie...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aer298

    authors: Benzon HT,McCarthy RJ,Benzon HA,Kendall MC,Robak S,Lindholm PF,Kallas PG,Katz JA

    更新日期:2011-12-01 00:00:00

  • Effect of segmental extradural analgesia on placental blood flow during normal labour.

    abstract::Placental blood flow was measured during the first stage of normal labour using a xenon-133 clearance technique before and after segmental extradural analgesia. Analgesia was produced with 0.5% plain bupivacaine in eight patients and with 0.5% bupivacaine--adrenaline in 10 patients. Segmental extradural analgesia with...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/50.6.563

    authors: Jouppila R,Jouppila P,Hollmén A,Kuikka J

    更新日期:1978-06-01 00:00:00

  • Effects of hypothermia on thrombelastography in patients undergoing cardiopulmonary bypass.

    abstract::Thrombelastography (TEG) correlates with postoperative chest drain output in patients undergoing cardiopulmonary bypass (CPB). In vitro incubation with heparinase allows TEG monitoring during CPB, despite heparin anticoagulation. Hypothermia impairs coagulation, but these effects cannot be assessed by standard coagula...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/80.3.313

    authors: Kettner SC,Kozek SA,Groetzner JP,Gonano C,Schellongowski A,Kucera M,Zimpfer M

    更新日期:1998-03-01 00:00:00

  • Haemodynamic effects of pretreatment with metoprolol in hypertensive patients undergoing surgery.

    abstract::Thirty hypertensive patients scheduled for cholecystectomy or hernia repair under general anaesthesia with thiopentone-fentanyl-nitrous oxide-pancuronium were divided into two groups of 15. One group received metoprolol tablets 200 mg in a slow release form, once daily for at least 2 weeks including the morning of sur...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/58.3.251

    authors: Magnusson J,Thulin T,Werner O,Järhult J,Thomson D

    更新日期:1986-03-01 00:00:00

  • Opioid-induced hyperalgesia in patients after surgery: a systematic review and a meta-analysis.

    abstract:BACKGROUND:Opioids can increase sensitivity to noxious stimuli and cause opioid-induced hyperalgesia. We performed a systematic review to evaluate the clinical consequences of intra-operative doses of opioid. METHODS:We identified randomized controlled trials which compared intra-operative opioid to lower doses or pla...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,meta分析,评审

    doi:10.1093/bja/aeu137

    authors: Fletcher D,Martinez V

    更新日期:2014-06-01 00:00:00

  • Heat and moisture exchangers in artificial ventilation. An experimental study of the effect of gas leakage.

    abstract::The effect of gas leakage around an uncuffed tracheal tube on the performance of Heat and Moisture Exchangers (HME) was examined experimentally. Such leaks were shown to cause measurable decreases in the humidity output and efficiency of HME. The magnitude of the decrease in humidity output was shown to be dependent u...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/59.9.1181

    authors: Tilling SE,Hayes B

    更新日期:1987-09-01 00:00:00

  • Technique training: endoscopic percutaneous tracheostomy.

    abstract::Percutaneous tracheostomy is being used increasingly in the intensive care unit and endoscopic control of this procedure affords an improved level of safety. Training in such new minimal access techniques can be a significant risk factor in patient outcome. Surgical simulation provides training which minimizes this ri...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/81.3.401

    authors: Gardiner Q,White PS,Carson D,Shearer A,Frizelle F,Dunkley P

    更新日期:1998-09-01 00:00:00

  • Effect of high-dose preoperative methylprednisolone on recovery after total hip arthroplasty: a randomized, double-blind, placebo-controlled trial.

    abstract:BACKGROUND:High-dose glucocorticoid may reduce postsurgical pain and improve recovery. We hypothesized that 125 mg methylprednisolone (MP) would reduce time to meet functional discharge criteria after total hip arthroplasty (THA). METHODS:Forty-eight patients undergoing unilateral THA under spinal anaesthesia were con...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/bja/aes345

    authors: Lunn TH,Andersen LØ,Kristensen BB,Husted H,Gaarn-Larsen L,Bandholm T,Ladelund S,Kehlet H

    更新日期:2013-01-01 00:00:00

  • Myocardial metabolism during anaesthesia with propofol--low dose fentanyl for coronary artery bypass surgery.

    abstract::We have studied the haemodynamic and myocardial effects of propofol-fentanyl anaesthesia in 12 patients undergoing coronary artery bypass surgery during the pre-bypass period. The induction dose of propofol was 1.5 mg kg-1 and mean infusion rate during maintenance was 4.48 mg kg-1 h-1 (range 1.87-7.24 mg kg-1 h-1). Th...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/66.4.504

    authors: Vermeyen KM,De Hert SG,Erpels FA,Adriaensen HF

    更新日期:1991-04-01 00:00:00

  • Periodic cardiovascular and ventilatory activity during midazolam sedation.

    abstract::We have examined the effects of sedation with midazolam 0.1 mg kg-1 and reversal with flumazenil 0.5 mg on beat-to-beat heart rate (HR) variability (HRV), systolic arterial pressure (SAP), finger photoplethysmograph amplitude (PLA) and impedence pneumography in eight volunteers. With the onset of sedation there was a ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/76.4.503

    authors: Galletly DC,Williams TB,Robinson BJ

    更新日期:1996-04-01 00:00:00

  • Ventilation with low tidal volumes during upper abdominal surgery does not improve postoperative lung function.

    abstract:BACKGROUND:Prolonged postoperative decrease in lung function is common after major upper abdominal surgery. Evidence suggests that ventilation with low tidal volumes may limit the damage during mechanical ventilation. We compared postoperative lung function of patients undergoing upper abdominal surgery, mechanically v...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/bja/aes140

    authors: Treschan TA,Kaisers W,Schaefer MS,Bastin B,Schmalz U,Wania V,Eisenberger CF,Saleh A,Weiss M,Schmitz A,Kienbaum P,Sessler DI,Pannen B,Beiderlinden M

    更新日期:2012-08-01 00:00:00

  • Naloxone improves functional recovery of myocardial stunning in conscious dogs through its action on the central nervous system.

    abstract::This study tests the hypothesis that naloxone, but not its quarternary salt, naloxone methiodide (which does not enter the central nervous system), improves recovery from myocardial stunning in conscious dogs. Twenty dogs were chronically instrumented for measurement of heart rate, left atrial, aortic and left ventric...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/86.4.545

    authors: Weber TP,Stypmann J,Meissner A,Hartlage MG,Van Aken H,Rolf N

    更新日期:2001-04-01 00:00:00

  • Microdialysis study of the blood-brain equilibration of thiopental enantiomers.

    abstract::Thiopental is a racemate of equimolar R- and S-thiopental enantiomers that have different potencies in laboratory experiments. We measured concentrations of R- and S-thiopental in plasma, tissues and brain microdialysate of rats after computer-controlled infusion of thiopental i.v. to a plasma concentration of 40 micr...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.bja.a013385

    authors: Mather LE,Edwards SR,Duke CC,Cousins MJ

    更新日期:2000-01-01 00:00:00

  • Adverse effects of extradural and intrathecal opiates: report of a nationwide survey in Sweden.

    abstract::The Swedish Society of Anaesthetists conducted a nationwide retrospective survey of clinical experience with extradural and intrathecal opiates. Special interest was focused on the frequency and type of ventilatory depression. The questionnaire was answered by 84 of 93 departments (90%). Up to May 1981 extradural morp...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/54.5.479

    authors: Gustafsson LL,Schildt B,Jacobsen K

    更新日期:1982-05-01 00:00:00

  • Evaluation of an uncalibrated arterial pulse contour cardiac output monitoring system in cirrhotic patients undergoing liver surgery.

    abstract:BACKGROUND:The pulmonary artery catheter is invasive and may cause serious complications. A safe method of cardiac output (CO) measurement is needed. We have assessed the accuracy and reliability of a recently marketed self-calibrating arterial pulse contour CO monitoring system (FloTrac/Vigileo) in end-stage liver fai...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aen343

    authors: Biancofiore G,Critchley LA,Lee A,Bindi L,Bisà M,Esposito M,Meacci L,Mozzo R,DeSimone P,Urbani L,Filipponi F

    更新日期:2009-01-01 00:00:00

  • Use of alcuronium in patients undergoing renal transplantation.

    abstract::Alcuronium 0.16 mg kg-1 was used to provide neuromuscular blockade in patients with chronic renal failure undergoing renal transplantation. Relaxation was found to be adequate for intubation and surgery. There were minimal alterations to cardiovascular variables. The dose required was small, and complete reversal occu...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/56.11.1229

    authors: Kaushik S,Grover VK,Singh H,Yadav RV

    更新日期:1984-11-01 00:00:00

  • Diagnostic and management dilemmas in a patient with tracheal trauma.

    abstract::A patient with a foreign body penetrating the neck and chest was found to have physical signs which were consistent with serious tracheal injury and included a large movement of air through the lower part of the neck. The subsequent management of the patient and the difficult problem of securing an airway are describe...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/66.6.724

    authors: Brierley JK,Oates J,Bogod DG

    更新日期:1991-06-01 00:00:00

  • Lipid emulsion pretreatment has different effects on mepivacaine and bupivacaine cardiac toxicity in an isolated rat heart model.

    abstract:BACKGROUND:The use of lipid emulsions to reduce cardiac toxicity of local anaesthetics (LAs) has shown success in experimental studies and some clinical cases, and thus has been implemented in clinical practice. However, lipid treatment is usually given after the occurrence of neurological or cardiovascular symptoms of...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aet353

    authors: Aumeier C,Kasdorf B,Gruber M,Busse H,Wiese CH,Zink W,Graf BM,Zausig YA

    更新日期:2014-04-01 00:00:00

  • Influence of spinal and general anaesthesia on haemostasis during total hip arthroplasty.

    abstract::One hundred and one patients with osteoarthritis were randomly allocated to undergo total hip arthroplasty under either spinal (subarachnoid) or general anaesthesia. Venous blood was sampled before, during and after surgery and on the 5th day after operation to study the haemostatic mechanism. There were no preoperati...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/59.5.561

    authors: Davis FM,McDermott E,Hickton C,Wells E,Heaton DC,Laurenson VG,Gillespie WJ,Foate J

    更新日期:1987-05-01 00:00:00

  • Effects of thoracic epidural anaesthesia on microvascular gastric mucosal oxygenation in physiological and compromised circulatory conditions in dogs.

    abstract:BACKGROUND:The effects of thoracic epidural anaesthesia (TEA) on gastric mucosal microvascular haemoglobin oxygenation (microHbO(2)) are unclear. At the splanchnic level, reduction of sympathetic tone may promote vasodilation and increase microHbO(2). However, these splanchnic effects are counteracted by systemic effec...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aeh235

    authors: Schwarte LA,Picker O,Höhne C,Fournell A,Scheeren TW

    更新日期:2004-10-01 00:00:00