Opioid-sparing Effects of Ketorolac and Its Correlation With the Recovery of Postoperative Bowel Function in Colorectal Surgery Patients

Chen, Jui-Yuan; Ko, Tsung-Lin; Wen, Yeong-Ray; Wu, S. H.; Chou, Yenn‐Hwei; Yien, Hwey-Wen; Kuo, Cheng–Deng

doi:10.1097/ajp.0b013e31819a506b

Cited by 100 publications

(105 citation statements)

References 23 publications

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“…None of the analyses provided any indication that the use of non-opioid antipyretic analgesics is associated with comparatively favourable point-estimators in chronic pain treatment. Non-opioid antipyretic analgesics failed to be associated with significantly lower pain scores, lower opioid doses or fewer side effects during opioid therapy, as was expected from the literature [2][3][4][5][6][7]. Despite similar or even higher opioid doses, the co-administration of nonopioid analgesics was not associated with further reduced pain scores in addition to those observed with opioids alone.…”

Section: Discussionsupporting

confidence: 57%

“…They are the first-line treatment for mild pain. In combination with opioids, they are thought to provide synergistic analgesic effects [2,3], opiate-sparing [4][5][6] and reduced side effects [7], although combined side effects may still occur [8,9]. The positive effects of non-opioid antipyretic analgesics are usually obtained in well-defined settings with homogenous cohorts of pain patients.…”

Section: Introductionmentioning

confidence: 99%

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Higher pain scores, similar opioid doses and side effects associated with antipyretic analgesics in specialised tertiary pain care

et al. 2010

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Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Higher pain scores, similar opioid doses and side effects associated with antipyretic analgesics in specialised tertiary pain care

et al. 2010

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“…Ketorolac added to morphine (Chen, Wu et al, 2005 Level II; Chen et al, 2009 Level II) or tramadol (Lepri et al, 2006 Level II) PCA did not improve pain relief or alter the incidence of side effects, however it was opioid-sparing and led to earlier return of bowel function after colorectal surgery Level II).…”

Section: Other Adjuvantsmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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“…Intravenous opioids, while effective at pain control, contribute to delayed bowel function [20] and may extend a patient's hospital stay unnecessarily. Epidural anesthesia is an excellent adjunct for patients undergoing ileostomy reversal, as it is for many surgical procedures.…”

Section: Discussionmentioning

confidence: 98%

The analgesic efficacy of transversus abdominis plane blocks in ileostomy takedowns: a retrospective analysis

Amlong

Schroeder

Andrei³

et al. 2012

Journal of Clinical Anesthesia

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Opioid-sparing Effects of Ketorolac and Its Correlation With the Recovery of Postoperative Bowel Function in Colorectal Surgery Patients

Cited by 100 publications

References 23 publications

Higher pain scores, similar opioid doses and side effects associated with antipyretic analgesics in specialised tertiary pain care

Higher pain scores, similar opioid doses and side effects associated with antipyretic analgesics in specialised tertiary pain care

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

The analgesic efficacy of transversus abdominis plane blocks in ileostomy takedowns: a retrospective analysis

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