The Effects of Ketorolac Used for Postoperative Analgesia on Hemostatic Function: A Thromboelastographic Evaluation / 대한마취과학회지

ABSTRACT

BACKGROUND: Thromboelastography (TEG) has recently become popular for assessment of whole blood coagulation in the operating room. Ketorolac, a potent injectable nonsteroidal anti-inflammatory drug (NSAID), is commonly used for postoperative analgesia. NSAID inhibit platelet aggregation in coagulation process. This study was designed to determine whether ketorolac used for postoperative analgesia can affect hemostatic function using a TEG. METHODS: Seventy-four female patients, ASA physical status 1 or 2, scheduled for an elective gynecologic surgery were randomly allocated into one of four groups (Group 1 n = 10, control without patient-controlled analgesia (PCA); Group 2 n = 21, PCA with morphine 60 mg; Group 3 n = 20, PCA with morphine 30 mg + ketorolac 90 mg; Group 4 n = 23, PCA with ketorolac 180 mg). Blood samples were obtained for TEG analysis preoperatively and 24, 48 and 72 h after surgery. Cumulative drug dosage, visual analog pain scale, satisfaction degree and side effects were measured at 24, 48 and 72 h after surgery. RESULTS: There were no significant differences in TEG parameters among the four groups at each time. There were no significant differences in visual analog pain scales and satisfaction degrees among the three groups using PCA for postoperative analgesia. Among the three groups using PCA for postoperative analgesia, Group 2 experienced more side effects. CONCLUSIONS: Ketorolac does not affect hemostatic function for 3 days after surgery when administrated as a PCA drug.