Co-analgesic effect of ketorolac after thoracic surgery

Thoracotomies are painful surgical procedures and adequate pain relief is associated with improved respiratory function and fewer respiratory complications. After thoracotomy for lung resection, patients received morphine-based patient-controlled analgesia (PCA). Three groups were prospectively and randomised investigated: patients receiving preemptive ketorolac, those given postoperative ketorolac and controls. No differences among groups were found for demographic data, anaesthesia and surgery durations, or for the amounts of anaesthesia drugs administered. The blood losses were also comparable: 565 +/- 374 ml for the preemptive ketorolac group. 749 +/- 491 ml for the postoperative ketorolac group and 674 +/- 323 ml for the controls. At 48 h after surgery, compared to controls, morphine consumption was 36% lower for the preemptive ketorolac group and 17% lower for postoperative ketorolac group (p < 0.05). No statistically significant differences were observed for pulmonary function tests. These results suggest that non-steroidal anti-inflammatory drugs can reduce the opioid requirements after thoracic surgery but do not improve lung function.