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二之(二)應該說是孕婦比較好,避免誤會....

好像應該是二之(一)?
不過,由參考資料二看來,似乎是「產婦」而不是「孕婦」?


我的天啊。這個東西是『發文日期:中華民國97年9月9日』?我之前只有注意到一張公文說:禁止用Keto退燒,當然這個早就知道了。

從97年9月至今,我還是給一些C/S完喊宮縮不舒服的產婦用過Keto耶。幸好都沒有發生PPH,否則一張公文在這裡,我一定被告死了。

謝謝站長在我出事前,即時救了我。(雖然我還是懷疑真的不能打嗎?就像曾經聽過某老外小兒麻醉巨擘說過,tonsillectomy 完禁用Keto,不是怕bleeding,而是怕被小外醫師牽拖到....)

請問站長為何突然貼出這則公告呢?願意分享嗎?

朋友提醒的。

理論上C/S完喊宮縮不舒服的應該可以用Keto.
NSAID是治療產後子宮收縮疼痛的唯一利器, 連嗎啡都不夠力

僅僅是不適合哺喂母乳,生產前,或生產過程中使用,
就要無限上綱到整個產科都不能用?

這也管太多了吧,很有爭議哦

如果沒有衛生署的這一條奇怪的規定, Ketorolac 應該是可以用在 reduce uterine cramping pain 及 postcesarean analgesia.

-------------------

Google的 Obstetric Anesthesia 第492頁
http://ppt.cc/dn6L

Roche (manufacturer) has stated that ketorolac is contraindicated
in nursing mothers because of the possible adverse effects of
prostaglandin synthetase inhibitors on neonates.

In contrast, the American Academy of Pediatrics considers ketorolac
to be compatible with breast feeding.

In late pregnancy, as with other NSAIDs, TORADOL(Ketorolac) should be avoided
because it may cause premature closure of the ductus arteriosus.

哇!每個 PCA 的處方我都有加 Ketorolac!


反正『公告』都出來了。我怕被告,說什麼都不用了。
(不知道現在還有人C/S完IV PCA 用morphine + keto嗎?)

我們的配方加回keto了!因應怪異的婦產科,沒加的話,剖腹產完,術後止痛效果差!

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