目的:关于儿童患者围手术期使用酮咯酸的扁桃体切除术后出血风险存在矛盾的证据。扁桃体切除术的手术技术可以进一步混淆这种风险。
目的:主要目的是回顾性量化小儿扁桃体囊内切除术后单剂量酮咯酸给药后扁桃体切除术后出血率。次要目标是确定年龄,性别,身体质量指数,医疗合并症,和手术指征增加了扁桃体切除术后出血的风险。
方法:在2017年1月至2018年12月期间,对1920名接受囊内扁桃体切除术的儿童进行回顾性队列研究。
方法:本研究在三级儿科转诊中心完成。
方法:1920名在2017年1月至2018年12月期间在一家三级保健儿童医院接受囊内扁桃体切除术的儿童。
■患者分为两组:1458例患者(75.9%)接受酮咯酸(K),462(24.1%)没有(NK)。年龄,性别,身体质量指数,合并症,我们还评估了手术指征与扁桃体切除术后出血风险的相关性.
■两组的主要研究结果均为需要手术干预的扁桃体切除术后出血。
结果:1920名研究参与者被纳入,平均年龄为6.5岁;51.5%的参与者是男性;63.9%为白色。总的来说,术后出血率为1.5%。然而,比较酮咯酸组和非酮咯酸组的出血率没有显着差异(1.4%-1.7%;P=.82)年龄,慢性扁桃体炎,较高的体重指数Z评分,注意力缺陷/多动障碍,和行为诊断是扁桃体切除术后出血的统计学显著危险因素。
结论:在接受囊内扁桃体切除术的小儿患者中,术后单剂量酮咯酸似乎与扁桃体切除术后出血风险增加无关。由于担心出血风险,提供者不应避免在进行囊内扁桃体切除术的患者中使用酮咯酸。
OBJECTIVE: Conflicting evidence exists regarding the post-tonsillectomy bleed risk associated with perioperative ketorolac use in the pediatric population. Surgical technique for tonsillectomy can further confound this risk.
OBJECTIVE: The primary objective was to retrospectively quantify the post-tonsillectomy bleed rate after single-dose administration of ketorolac in pediatric patients following intracapsular tonsillectomy. The secondary objective was to determine if age, sex, body mass index, medical comorbidities, and indication for surgery increased post-tonsillectomy bleed risk.
METHODS: Retrospective cohort study of 1920 children who underwent intracapsular tonsillectomies between January 2017 and December 2018.
METHODS: This study was completed at a tertiary-care pediatric referral center.
METHODS: 1920 children who underwent intracapsular tonsillectomies between January 2017 and December 2018 at a single tertiary-care children\'s hospital.
UNASSIGNED: Patients were divided into two cohorts: 1458 patients (75.9%) received ketorolac (K+), and 462 (24.1%) did not (NK). Age, sex, body mass index, comorbidities, and indication for surgery also were evaluated for association with post-tonsillectomy bleed risk.
UNASSIGNED: Primary study outcome for both cohorts was post-tonsillectomy hemorrhage requiring operative intervention.
RESULTS: 1920 study participants were included with an average age of 6.5 years; 51.5% of participants were males; and, 63.9% were white. Overall, the postoperative bleeding rate was 1.5%. However, there was no significant difference when comparing bleeding rates for the ketorolac group and the non-keterolac group (1.4%-1.7%; P = .82) Age, chronic tonsillitis, higher body mass index Z-scores, attention-deficit/hyperactivity disorder, and behavioral diagnoses were statistically significant risk factors for post-tonsillectomy hemorrhage.
CONCLUSIONS: Single-dose postoperative ketorolac does not appear to be associated with increased risk of post-tonsillectomy bleed in pediatric patients undergoing intracapsular tonsillectomy. Providers should not avoid using ketorolac in patients undergoing intracapsular tonsillectomy due to concerns over bleeding risk.