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

 Jeong-Yeon Hong  ;  Sang Won Han  ;  Won Oak Kim  ;  Hae Keum Kil 
 JOURNAL OF UROLOGY, Vol.183(4) : 1551-1555, 2010 
Journal Title
Issue Date
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
acetaminophen ; analgesia ; ketorolac ; pain ; postoperative ; pediatrics
PURPOSE: 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
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kil, Hae Keum(길혜금)
Kim, Won Oak(김원옥)
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
Hong, Jeong Yeon(홍정연)
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