在自控式疼痛控制術配方中加入Ketorolac可減少噁心嘔吐發生率

The Addition of Ketorolac to a Patient-Controlled Analgesia Regimen Reduces the Incidence of Postoperative Nausea and Vomiting

背景：IV-PCA已經使用於術後疼痛控制數十年了，但PCA相關的術後噁心嘔吐（PCA­PONY）卻依然是擾人的問題，有時病人也可能因PCA-PONV而拒絕使用PCA。本研究在於評估加入ketorolac至PCA配方是否可以降低PCA-PONV的發生率。方法：吾人以兩年的PCA記錄並排除符合排除標準的病人。依據PCA的配方將病人分為兩組。A組，PCA溶液含有ketorolac而B組則PCA溶液則不合ketorolacO以術後72小時的PONY之發生率為觀察指標。並以chi-square分析之且以P<0.05為有意義。結果：吾人結果顯示A組之PCA-PONV發生率為9.2萬較B組之14.7%明顯降低。結論：如入ketorolac至PCA配方可以有效降低PCA-PONV的發生率。是值得採行的方法。

Background: Intravenous patient-controlled analgesia (IV-PCA) has been used over decades for postoperative pain control, but PCA-associated postoperative nausea and vomiting (PCA-PONV) is a troublesome problem and may deter patients from using PCA. We conducted the current study to evaluate whether the addition ofketorolac to the PCA regimen reduced the incidence of PCA-PONY. Methods: We conducted a two-year review of IV-PCA records, and these patients were divided into two groups according to PCA regimens. Patients in group A received a PCA regimen with ketorolac, while patients in group B received a PCA regimen without ketorolac. The outcome data measured any nausea, vomiting or both during the first 72 postoperative hours. Categorical data were presented as numbers and percentages and were analyzed by chi-square test and P< 0.05 was considered significant. Results: The incidence of PCA-PONV in group A was significantly lower than that in group B (9.2% v.s.14.7%, P< 0.05). Conclusion: The addition of ketorolac into IV-PCA mixtures significantly reduced the incidence of PCA-PONV.