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Ketorolac possesses analgesic potency against postoperative pain

05 Oct 2017

Ketorolac-based analgesics demonstrate substantial local infiltration during treatment of pain in patients who have undergone breast surgery, according to a study. Locally administered ketorolac substantially reduces postoperative pain, and the effect is better than local bupivacaine.

Researchers performed a systemic review and meta-analysis on the efficacy of locally administered ketorolac-based analgesics in managing pain after breast surgery. The main study outcome was pain level, measured using a visual analogue scale (VAS) at 1 and 6 hours following surgery.

Pooled data from four randomized controlled trials, involving 255 patients, showed that VAS pain scores at 1 hour postsurgery were significantly lower among patients administered a ketorolac solution (weighted mean difference [WMD], -2.04; 95 percent CI, -3.08 to -1.00) or ketorolac-bupivacaine solution (WMD, -2.30; -4.07 to -0.54) relative to controls.

At the 6-hour time point, VAS pain scores were markedly reduced with the ketorolac-bupivacaine solution than with controls (WMD, -1.40; -2.48 to -0.32). However, at 1 hour, the ketorolac solution was superior in efficacy compared with the bupivacaine solution (WMD, -1.70; -2.81 to -0.59).

Ketorolac was the first nonsteroidal anti-inflammatory drug to be approved in the US for intravenous (IV) use in the management of postoperative pain in both adults and children. In children, the drug is used in the postoperative setting for procedures such as general, otolaryngological, urological, cardiac, trauma and orthopaedic surgeries, as well as ophthalmology procedures, and chest tube placement and removal. [J Pain Res 2010;3:67-79; Anesthesiology 2015;122:150-71; Pediatr Ann 2014;43:e169-75]

Ketorolac can be administered orally or parenterally as either IV or intramuscular. The parenteral route of administration is preferable in the immediate postoperative period, as the gastrointestinal tract may be compromised as a consequence of postoperative ileus or due to increased predisposition to nausea and vomiting after receipt of anaesthetic drugs during surgery. [Cochrane Database Syst Rev 2017;doi:10.1002/14651858.CD012294]

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Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.