Elsevier

Journal of Clinical Anesthesia

Volume 6, Issue 1, January–February 1994, Pages 23-27
Journal of Clinical Anesthesia

Original contribution
Intravenous ketorolac as an adjunct to patient controlled analgesia (PCA) for management of postgynecologic surgical pain

https://doi.org/10.1016/0952-8180(94)90113-9Get rights and content
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Abstract

Study Objective: To determine whether intravenous (M doses of ketorolac tromethamine provide safe and effective augmentation of postsurgical analgesia for patients using IV patient-controlled analgesia (PCA) with morphine.

Design: Randomized, double-blind, placebo- controlled, dose-response evaluation.

Setting: Patient care unit at a university medical center.

Patients: 62 ASA physical status I–III females recovering from intro-abdominal gynecologic surgery with general anesthesia who requested postoperative PCA.

Interventions: Following initial pain assessment in the recovery room, patients were randomized to receive either IV saline (placebo) followed by IV saline every 6 hours (Group 1); IV ketorolac 30 mg loading dose followed by IV ketorolac 15 mg every 6 hours (Group 2); or N ketorolac 60 mg loading dose followed by IV ketorolac 30 mg every 6 hours (Group 3). All patients were provided IV PCA, which was programmed to provide 1.2 mg of morphine with a 6-minute lockout interval.

Measurements and Main Results: Visual analog scale (VAS) resting pain and satisfaction scores were measured every 2 to 12 hours. Cumulative PCA with morphine and the frequency and severity of side effects also were assessed. N ketorolac showed no clinically significant side effects. Group 2 patients experienced significant reductions in VAS resting pain scores (p < 0.05), and a trend toward decreased morphine self-administration in. both active groups was noted. Group 2 and Group 3 patients reported greater satisfaction with postsurgical analgesia than Group 1 patients. (p < 0.05).

Conclusions: IV ketorolac used as an analgesic adjunct provided safe and effective augmentation of PCA with morphine in patients recovering from intro-abdominal gynecologic surgery.

Keywords

Analgesia, postoperative
analgesia
intravenous delivery
ketorolac
morphine
patient-controlled analgesia

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Associate Professor

Research Nurse Specialist in Anesthesiology