Scholarlink

Background <p>Acute Type A Aortic Dissection (aTAAD) is a severe and life-threatening condition. While animal studies have suggested that ketorolac could slow the progression of aortic aneurysms and dissections, clinical data on its efficacy in aTAAD patients remain limited. This study seeks to evaluate the safety and effectiveness of ketorolac in this patient group.</p> Methods <p>Patients were randomly assigned to receive either ketorolac or a placebo (0.9% saline). Treatment began at least 2&#xa0;h prior to surgery (60&#xa0;mg ketorolac or 2&#xa0;ml saline administered once intramuscularly) and continued for 48&#xa0;h post-surgery (30&#xa0;mg ketorolac or 1&#xa0;ml saline administered intramuscularly twice daily). The primary endpoints included assessing the safety and efficacy of ketorolac in improving the prognosis of aTAAD, focusing on mortality and organ malperfusion syndrome. Secondary endpoints included drug-related adverse events, blood test results, and other postoperative outcomes.</p> Results <p>Of 179 patients who underwent aTAAD repair, 110 met the inclusion criteria and were randomized into two groups of 55. One patient discontinued the intervention due to erythroderma on the first postoperative day, leaving 54 patients in the ketorolac group and 55 in the placebo group for analysis. No significant differences were found in the primary endpoints. However, the ketorolac group showed lower intraoperative bleeding (median: 1.8 L vs. 2.0 L, <i>P</i> = 0.03), shorter intensive care unit (ICU) stays (median: 6.5&#xa0;days vs. 8&#xa0;days, <i>P</i> = 0.04), and lower total hospital costs (median: ¥170,430 vs. ¥187,730, <i>P</i> = 0.03).</p> Conclusions <p>Short-term ketorolac therapy did not alter the primary outcome but was associated with reduced intraoperative bleeding, shorter ICU stays, and potentially lower hospitalization costs. It demonstrates safety and a certain degree of effectiveness during the perioperative period. These findings suggest that ketorolac could be a viable option for perioperative management in patients with aTAAD.</p> Trial registration <p>The trial was registered at the Chinese Clinical Trial Register (<a href="http://www.chictr.org.cn">www.chictr.org.cn</a>, No: ChiCTR2300074394).</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Ketorolac in the perioperative management of acute type A aortic dissection: a randomized double-blind placebo-controlled trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年3月28日

查看全文
  • Zhi-Kang Lv,
  • Hai-Tao Zhang,
  • Xiu-Juan Cai,
  • Wen-Xin Su,
  • Er-Jun Zhu,
  • Hoshun Chong,
  • Xi-Yu Zhu,
  • You-Ru Kong,
  • Yu-Xian Tang,
  • Xin Li,
  • Yuan-Xi Luo,
  • Han-Qing Luo,
  • Hao-Dong Pan,
  • Yan-Hua Sun,
  • Kai Li,
  • Min Jin,
  • Shu-Chun Li,
  • Hong-Yu Chen,
  • Ze-Qi Bi,
  • Ying-Liang Zhao,
  • Zhen-Jun Xu,
  • Yong-Qing Cheng,
  • Wan-Zi Xu,
  • Cheng Chen,
  • Wei-Wei Zhao,
  • Zhi-Gang Wang,
  • Li-Chong Lu,
  • Jun Pan,
  • Fu-Dong Fan,
  • Yun-Xing Xue,
  • Bo-Ming Zhang,
  • Min Ge,
  • Jia-Xin Ye,
  • Chui-Yu Kong,
  • Bao-Dong Xie,
  • Tuo Pan,
  • Dong-Jin Wang

摘要

Background

Acute Type A Aortic Dissection (aTAAD) is a severe and life-threatening condition. While animal studies have suggested that ketorolac could slow the progression of aortic aneurysms and dissections, clinical data on its efficacy in aTAAD patients remain limited. This study seeks to evaluate the safety and effectiveness of ketorolac in this patient group.

Methods

Patients were randomly assigned to receive either ketorolac or a placebo (0.9% saline). Treatment began at least 2 h prior to surgery (60 mg ketorolac or 2 ml saline administered once intramuscularly) and continued for 48 h post-surgery (30 mg ketorolac or 1 ml saline administered intramuscularly twice daily). The primary endpoints included assessing the safety and efficacy of ketorolac in improving the prognosis of aTAAD, focusing on mortality and organ malperfusion syndrome. Secondary endpoints included drug-related adverse events, blood test results, and other postoperative outcomes.

Results

Of 179 patients who underwent aTAAD repair, 110 met the inclusion criteria and were randomized into two groups of 55. One patient discontinued the intervention due to erythroderma on the first postoperative day, leaving 54 patients in the ketorolac group and 55 in the placebo group for analysis. No significant differences were found in the primary endpoints. However, the ketorolac group showed lower intraoperative bleeding (median: 1.8 L vs. 2.0 L, P = 0.03), shorter intensive care unit (ICU) stays (median: 6.5 days vs. 8 days, P = 0.04), and lower total hospital costs (median: ¥170,430 vs. ¥187,730, P = 0.03).

Conclusions

Short-term ketorolac therapy did not alter the primary outcome but was associated with reduced intraoperative bleeding, shorter ICU stays, and potentially lower hospitalization costs. It demonstrates safety and a certain degree of effectiveness during the perioperative period. These findings suggest that ketorolac could be a viable option for perioperative management in patients with aTAAD.

Trial registration

The trial was registered at the Chinese Clinical Trial Register (www.chictr.org.cn, No: ChiCTR2300074394).