COMPARISON OF WOUND INFILTRATION WITH KETOROLAC VERSUS INTRAVENOUS REGIONAL ANESTHESIA WITH KETOROLAC FOR POSTOPERATIVE ANALGESIA FOLLOWINGAMBULATORY HAND SURGERY
Ss. Reuben et Km. Duprat, COMPARISON OF WOUND INFILTRATION WITH KETOROLAC VERSUS INTRAVENOUS REGIONAL ANESTHESIA WITH KETOROLAC FOR POSTOPERATIVE ANALGESIA FOLLOWINGAMBULATORY HAND SURGERY, Regional anesthesia, 21(6), 1996, pp. 565-568
Background and Objectives. The purpose of this study was to assess the
analgesic effectiveness of ketorolac administered with lidocaine via
intravenous regional asesthesia (IVRA) or via wound infiltration follo
wing ambulatory hand surgery. Methods. The patient population in this
double-blind study consisted of 60 patients scheduled for elective amb
ulatory hand surgery, who were divided into three groups of 20 each. A
ll patients received IVRA with 40 mL 0.5% lidocaine and 5 mL 1% lidoca
ine infiltrated into the surgical site. Group 1, the control group, re
ceived no additional medications; group 2 had 60 mg ketorolac added to
the lidocaine used for IVRA; and group 3 had 60 mg ketorolac added to
the lidocaine used for wound infiltration. Postoperative pain was ass
essed by a 10-cm visual analog scale, VAS) 1 hour and 2 hours after to
urniquet deflation. In the postanesthesia care unit analgesia was prov
ided with fentanyl until the VAS score reached 3 or lower. Patients we
re instructed to take one Tylenol No. 3 (acetaminophen with codeine) t
ablet every 4 hours as needed at home. They were contacted the next da
y, and the time to first additional narcotics and the total number of
tablets taken were recoded. Results. No differences in demographic var
iables or in operative, tourniquet, or discharge times were noted amon
g the groups. The VAS scores were significantly lower in the two group
s who received ketorolac than in the control group (P < .05); the mean
lime from tourniquet release to first medication was 109 +/- 73 minut
es for group 1,467 +/- 431 for group 2, and 393 +/- 312 for group 3 (P
< .05); and the number of tablets taken was 4.1 +/- 1.3 for group 1,
1.8 +/- 1.2 for group 2, and 2.0 +/- 1.3 for group 3 (P < .05). Conclu
sion. Ketorolac provides similar postoperative analgesia after ambulat
ory hand surgery when administered with lidocaine either by IVRA or by
wound infiltration.