Intravenous Ketorolac and Intravenous Acetaminophen Effect on Kidney Function and Morphine Intake During Postoperative Laparoscopic Bariatric Surgery at Maui Memorial Medical Center
Medicine and Health Sciences
Context: Obesity is a prevalent disease that presents with fatal comorbidities. However, Laparoscopic Roux-en Y gastric bypass surgery patients lose all excess weight within 2 years with proven remission of comorbidities like type II Diabetes Mellitus. Despite this success, surgeons at Maui Memorial Medical Center have cited rising postoperative creatinine and BUN levels resulting in increased hospitalizations. Objective: To compare renal function and opioid usage between IV ketorolac and IV acetaminophen during bariatric postoperative recovery. Setting: This is a cohort analysis of kidney function and morphine usage comparing two patient groups. Currently, in this context, these drugs are chosen by physician preference. Methods: Patients admitted to this study had comparable age, BMI, and sex at 95% confidence. To reduce variations in surgical trauma, the same surgeon performed all 107 surgeries. Patients eliminated from this study included those with complications during surgery, those with drug allergies or taking drugs known to induce drug interactions, those who required blood transfusions, kidney transplants, or hemodialysis. 2-sample T tests were conducted between the patient groups measuring creatinine, BUN, and hematocrit levels as well as morphine usage over the 24 hours postoperative period. Results: Hematocrit levels were higher with acetaminophen at 95% confidence (P = 0.0158). Creatinine also improved with acetaminophen, however not significantly, with p value of 0.0551. The differences concerning hemoglobin and BUN levels, and morphine usage were not significant. Conclusions: The data indicated that support for the usage of acetaminophen over ketorolac requires further investigation. Staff at Maui Memorial Medical Center are continuing this research using a double-blind cohort analysis aiming for 500 patients under the same parameters. However, they will measure kidney function at both 24 hours and 48 hours after surgery and utilize ANOVA.
Copyright 2018 all authors
Chasen, Joseph OMS-2; Machida, Chelsea; York, Dan Ph.D; and Chasen, Arthur MD, "Intravenous Ketorolac and Intravenous Acetaminophen Effect on Kidney Function and Morphine Intake During Postoperative Laparoscopic Bariatric Surgery at Maui Memorial Medical Center" (2018). MU-COM Research Day. 70.