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Fentanyl sparing effects of combined ketorolac and acetaminophen for outpatient inguinal hernia repair in children.

AbstractPURPOSE:
In this prospective, randomized, double-blinded study we sought to evaluate the efficacy and safety of combined use of intravenous ketorolac and acetaminophen in small children undergoing outpatient inguinal hernia repair.
MATERIALS AND METHODS:
We studied 55 children 1 to 5 years old who were undergoing elective repair of unilateral inguinal hernia. After induction of general anesthesia children in the experimental group (28 patients) received 1 mg/kg ketorolac and 20 mg/kg acetaminophen intravenously. In the control group (27 patients) the same volume of saline was administered. All patients received 1 microg/kg fentanyl intravenously before incision. We also evaluated the number of patients requiring postoperative rescue fentanyl, total fentanyl consumption, pain scores and side effects.
RESULTS:
Significantly fewer patients receiving ketorolac-acetaminophen received postoperative rescue fentanyl compared to controls (28.6% vs 81.5%). A significantly lower total dose of fentanyl was administered to patients receiving ketorolac-acetaminophen compared to controls (0.54 vs 1.37 microg/kg). Pain scores were significantly higher in the control group immediately postoperatively but eventually decreased. The incidences of sedation use (55.6% vs 25.0%) and vomiting (33.3% vs 10.7%) were significantly higher in controls.
CONCLUSIONS:
Preoperative intravenous coadministration of ketorolac and acetaminophen is a simple, safe and effective method for relieving postoperative pain, and demonstrates highly significant fentanyl sparing effects in small children after outpatient inguinal hernia repair.
AuthorsJeong-Yeon Hong, Sang Won Han, Won Oak Kim, Hae Keum Kil
JournalThe Journal of urology (J Urol) Vol. 183 Issue 4 Pg. 1551-5 (Apr 2010) ISSN: 1527-3792 [Electronic] United States
PMID20172547 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
CopyrightCopyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Analgesics, Non-Narcotic
  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Acetaminophen
  • Fentanyl
  • Ketorolac
Topics
  • Acetaminophen (administration & dosage)
  • Ambulatory Surgical Procedures
  • Analgesics, Non-Narcotic (administration & dosage)
  • Analgesics, Opioid (administration & dosage)
  • Anti-Inflammatory Agents, Non-Steroidal (administration & dosage)
  • Child, Preschool
  • Double-Blind Method
  • Drug Therapy, Combination
  • Fentanyl (administration & dosage)
  • Hernia, Inguinal (surgery)
  • Humans
  • Infant
  • Infusions, Intravenous
  • Ketorolac (administration & dosage)
  • Pain, Postoperative (prevention & control)
  • Prospective Studies

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