Efficacy of scheduled time ketorolac administration compared to continuous infusion for post-operative pain after abdominal surgery

A. Russo, E. Di Stasio, F. Bevilacqua, S. Cafarotti, A. Scarano, E. Marana

Department of Anaesthesiology and Intensive Care Medicine, Institute of Biochemistry and Clinical Biochemistry, and Division of Thoracic Surgery; School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. e.distasio@rm.unicatt.it

 

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• Pharmacology

BACKGROUND: Ketorolac tromethanime is a non steroidal anti inflammatory drug and its efficacy on acute pain control after abdominal surgery has been well documented. It has a rapid onset and it can be given both for intra operative and for post operative pain management.

AIM: In this study we aimed to evaluate if there were any differences in relieving post operative pain when Ketorolac was administered with continuous infusion or if it was given at prearranged times.

PATIENTS AND METHODS: 80 ASA I patients, scheduled for major gynecological surgery, were randomly assigned to 2 groups: group A patients were connected after surgical incision with a 24h analgesic infusor (2 ml/h) containing morphine (0.02 mg/kg/h) and Ketorolac (90 mg). Group B patients were connected after surgical incision with a 24h analgesic infusor (2 ml/h) containing morphine (0.02 mg/kg/h) at first and Ketorolac was then given in bolus after surgical incision and then every 8 hours for the first 24 hours.
Post-operative pain scores were assessed using the Visual Analogue Scale (VAS) every 8 hours for 24 h. For a VAS value grater than 6, patients received Tramadol 100 mg.

RESULTS: Post-operative pain scores showed a better pain relief for patients in the group B. Furthermore, the requirements of rescue analgesic were less in the group B [Tramadol was used for only 8 patients] than in the group A [Tramadol was used for 31 patients]. No adverse effects were registered in both groups.

CONCLUSIONS: For post-operative pain Ketorolac administration at prearranged times, every 8 hours, offers greater benefits in respect to its continuous infusion.

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