Division of Neurosurgery, Department of Surgery, Ascension Providence Hospital, Michigan State University, College of Human Medicine, Southfield, Michigan, USA.
Department of Pharmacy, Ascension Providence Hospital, Southfield, Michigan, USA.
BMJ Open. 2019 Jan 21;9(1):e025855. doi: 10.1136/bmjopen-2018-025855.
Ketorolac has been shown to provide quality postoperative pain control and decrease opioid requirement with minimal side effects following spinal surgery. However, the literature addressing its use in spinal fusions is highly variable in both its effectiveness and complications, such as pseudarthrosis. Recent literature postulates that ketorolac may not affect fusion rates and large randomised controlled trials are needed to demonstrate ketorolac as a safe and effective adjuvant treatment to opioids for postoperative pain control.
This is a multihospital, prospective, double-blinded, randomised placebo-controlled trial. Data concerning fusion rates, postoperative opioid use, pain scores, length of stay will be recorded with the aim of demonstrating that the use of ketorolac does not decrease thoracolumbar spinal fusion rates while identifying possible adverse events related to short-term minimal effective dose compared with placebo. Additionally, this investigation aims to demonstrate a decrease in postoperative opioid use demonstrated by a decrease in morphine equivalence while showing equivalent postoperative pain control and decrease the average length of stay.
Ethical approval was obtained at all participating hospitals by the institutional review board. The results of this study will be submitted for publication in peer-reviewed journals.
NCT03278691.
在脊柱手术后,酮咯酸已被证明能提供优质的术后疼痛控制并减少阿片类药物的需求,且副作用极小。然而,关于其在脊柱融合术中应用的文献在有效性和并发症(如假关节形成)方面差异很大。最近的文献推测酮咯酸可能不会影响融合率,需要进行大型随机对照试验来证明酮咯酸作为阿片类药物的安全有效的辅助治疗,以控制术后疼痛。
这是一项多医院、前瞻性、双盲、随机安慰剂对照试验。将记录融合率、术后阿片类药物使用、疼痛评分、住院时间等数据,目的是证明酮咯酸的使用不会降低胸腰椎脊柱融合率,同时与安慰剂相比,确定与短期最小有效剂量相关的可能不良事件。此外,该研究旨在通过减少吗啡等效物来证明术后阿片类药物使用减少,同时显示出等效的术后疼痛控制,并缩短平均住院时间。
所有参与医院的机构审查委员会均已获得伦理批准。该研究的结果将提交给同行评议的期刊发表。
NCT03278691。