酮咯酸氨丁三醇围术期使用情况分析及合理性评价

Analysis and rationality evaluation of the application of ketorolac tromethamine in perioperative period

目的调查酮咯酸氨丁三醇围术期镇痛中的临床使用情况并评价其用药合理性。方法采用回顾性调查方法对围术期使用酮咯酸氨丁三醇的临床使用情况进行分析,并从适应证、用法用量、用药疗程、联合用药和禁忌用药等方面进行合理性评价。结果酮咯酸氨丁三醇在围术期主要用于术中及术后的镇痛。本次调查所有病历中酮咯酸氨丁三醇的使用均符合药品适应证。其中不合理病历110份,不合理率32.9%,不合理情况共发生148例次,包括用法用量不合理74例次、疗程过长18例次、联合用药不适宜36例次,禁忌用药20例次。结论酮咯酸氨丁三醇在我院围术期存在不合理使用的情况,尤其用法用量和联合用药的问题,药师需加强医嘱点评并反馈于临床,临床医师应严格按照药品说明书、指南、共识等循证医学证据使用,以提高用药安全性。

AIM To investigate the clinical use of ketorolac tromethamine in perioperative analgesia and evaluate the rationality of drug use.METHODS By using the method of retrospective investigation,the use of ketorolac tromethamine during perioperative period was analyzed,and the rationality of indications,dosage and usage,medication course,combination of drugs,and contraindication was evaluated.RESULTS Ketorolac tromethamine was mainly used for intraoperative and postoperative analgesia in our hospital.The use of all the ketorolac tromethamine met its indications in this survey.There were 110 unreasonable medical records,with an unreasonable rate of 32.9%.The unreasonable problems occurred 148 times,including 74 cases of wrong usage and dosage,18 cases of long course of treatment,36 cases of improper combination,and 20 cases of drug contraindications.CONCLUSION There is an unreasonable use phenomenon of ketorolac tromethamine during perioperative period in our hospital,especially the unreasonable problem of dosage and usage and combined medication.Pharmacists need to strengthen the comment of doctor’s order and feed them back to the clinic.In order to improve safety of drug use,clinicians should strictly follow the evidence-based medicine,such as drug instructions,guidelines,and consensus,etc.