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Intraperitoneal ketorolac for post-cholecystectomy pain: a double-blind randomized-controlled trial
John Murdoch1, Gillian Ramsey2, Andrew G Day3
1Department of Anesthesiology & Perioperative Medicine, Victory 2, Kingston General Hospital, Queen's University, 76 Stuart Street, Kingston, ON, Canada, K7L 2V7. murdochj@kgh.kari.net.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|February 12, 2016
Summary
Intraperitoneal (IP) ketorolac offered comparable postoperative pain relief to intravenous (IV) ketorolac after laparoscopic cholecystectomy. This study found no significant advantage of IP ketorolac over IV administration for managing surgical pain.
Area of Science:
- Anesthesiology
- Surgical Pain Management
- Pharmacology
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ketorolac have localized anti-inflammatory properties.
- Postoperative pain management is crucial for patient recovery after laparoscopic cholecystectomy.
Purpose of the Study:
- To compare the analgesic efficacy of intraperitoneal (IP) ketorolac versus intravenous (IV) ketorolac.
- To evaluate the effectiveness of locally administered IP ketorolac for postoperative pain control during laparoscopic cholecystectomy.
Main Methods:
- 120 patients undergoing laparoscopic cholecystectomy were randomized into three groups: IP ketorolac, IV ketorolac, or control.
- Outcomes measured included postoperative fentanyl requirements, time to first analgesic request, pain scores, and complications.
Main Results:
- IP ketorolac required less fentanyl than the control group but similar amounts compared to the IV group.
- Time to first analgesic request was longer with IP ketorolac than control, but similar to IV ketorolac.
- Both IP and IV ketorolac reduced shoulder and resting pain compared to control, with no significant difference between IP and IV administration.
Conclusions:
- Off-label topical intraperitoneal administration of ketorolac showed no advantage over IV administration in this surgical population.
- Intraperitoneal and IV ketorolac demonstrated comparable analgesic efficacy following laparoscopic cholecystectomy.
