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Objective To evaluate the effect and safety of ketorolac on postoperative analgesia in patients undergoing percutaneous vertebroplasty.Methods The clinical data of patients who underwent percutaneous vertebroplasty in Xi'an Labor Union Hospital from January 2020 to May 2023 were retrospectively analyzed,and the patients were divided into ketorolac group and control group according to whether they were given ketorolac after surgery.The visual analogue pain score(VAS)before,6 h,24 h and 48 h after surgery,postoperative fentanyl usage(dosage,time of first compression analgesic pump,number of compressions),Oswestry disability index(ODI)before,3 days,1 month and 6 months after surgery,bone mineral density and bone metabolism indexes before,3 month and 6 month after surgery,the incidence of adverse reactions within 72 hours after surgery and satisfaction with pain intervention were compared between the two groups.Results A total of 90 patients were included in the study,including 48 patients in the ketorolac group and 42 patients in the control group.At 6 h,24 h and 48 h after surgery,the VAS score of the ketorolac group was significantly lower than that of the control group(P<0.05).The amount of fentanyl and the number of compressions in the ketorolac group were significantly lower than those in the control group,and the time of the first compression analgesic pump was significantly longer than that in the control group(P<0.05).There was no significant difference in bone mineral density,serum bone-specific alkaline phosphatase(BALP)and type I collagen C-terminal peptide(CTX-I)levels between the two groups before surgery(P>0.05).At 3 months and 6 months after surgery,the bone mineral density,serum BALP and CTX-I levels of the two groups were significantly improved compared with those before surgery(P<0.05).At 3 days,1 month and 6 months after surgery(P<0.05),the ODI of patients in both groups was significantly improved compared with that before surgery.There was no significant difference in the incidence of adverse reactions at 72 hours after surgery between patients in the ketorolac group and the control group(P>0.05).In addition,the satisfaction with pain relief in the ketorolac group was significantly higher than that in the control group(P<0.05).Conclusion Ketorlac can effectively improve the postoperative pain of patients with PVP without affecting the postoperative recovery of patients,with a low incidence of adverse reactions and a high safety profile,which can effectively improve patients'satisfaction with pain relief.
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Abstract Purpose: To investigate the effect of intravascular cooling on renal function after resuscitation. Methods: Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded. The bloods were analyzed for serum creatinine (sCr), CysC and NGAL. The kidney was surgically removed observe pathologic changes under a light microscope. Results: The sCr increased in both TH and NH groups after ROSC, compared to baseline. Between two groups, the sCr and creatinine clearance (Cc) showed lower level in the TH group. The urine volume per hour in the TH group were higher during cooling. After resuscitation, NGAL and CysC in the NH group were higher than in the TH group. Under the light microscope, compared with the TH group, the renal injury was prominent in the NH group. Conclusion: Mild hypothermia had a protection to renal ischemia reperfusion injury after resuscitation.