EFFICACY OF KETOROLAC TROMETHAMINE AND EXTRAPLEURAL INTERCOSTAL NERVEBLOCK ON POSTTHORACOTOMY PAIN - A PROSPECTIVE, RANDOMIZED STUDY

Background. Post-thoracotomy pain causes severe impairment of the resp iratory function, Epidural analgesia is effective in the treatment of post-thoracotomy pain but may give rise to significant side-effects, O ther low-risk and cost-effective analgesic treatments are therefore re quired. Methods. Thirty male patients who had undergone pulmonary Iobe ctomy entered a prospective, randomized trial to evaluate the efficacy of ketorolac tromethamine (Group 2) and extrapleural intercostal nerv e block (Group 3) with intermittent low-dose bupivacaine, Objective an d subjective assessment was carried out at 8, 16, 24 and 48 hours post operatively. Results. There were no significant differences between Gr oups 1 (control group) and 2, Vital capacity was significantly lower i n Group 3 (p<0.05) than in Group 1 after 16 hours, Forced Vital Capaci ty was significantly higher in Group 2 than in Group 3 after 16 and 24 hours (p<0.05), Peak expiratory Bow was also significantly better in Group 2 than in Group 3 after 16 hours (p<0.05). On-demand opioid cons umption was significantly lower in Group 2 (p<0.001) and Group 3 (p<0. 05), No side-effects were observed. Conclusions. Ketorolac tromethamin e was effective in the treatment of post-thoracotomy pain, Extrapleura l intercostal nerve block allowed a significant reduction in the consu mption of opioids, These analgesic techniques could be useful as low-r isk, cost-effective and reproducible treatments when more effective te chniques, such as epidural analgesia, are contraindicated.