POSTOPERATIVE EFFECTS OF FENTANYL, KETOROLAC, AND PIROXICAM AS ANALGESICS FOR OUTPATIENT LAPAROSCOPIC PROCEDURES

Objective: To compare postoperative analgesia and side effects of intr amuscular ketorolac, intravenous fentanyl, and oral piroxicam on healt hy women undergoing laparoscopic surgery. Methods: The study was a ran domized double-blind clinical trial of three analgesic drugs. An initi al 100-mu g dose of fentanyl was given at induction, with 25-mu g bolu ses after 45 and 90 minutes of operating time. Piroxicam, 40 mg, and k etorolac, 60 mg, were administered 90 and 30 minutes before induction, respectively. Results: Eighty-four subjects were included in the anal ysis. Ketorolac patients (N = 29) spent significantly less time in the recovery room (median 96 minutes) than those receiving fentanyl (N = 27) (median 121 minutes; P <.01) or piroxicam (N = 28) (median 124 min utes; P <.01). Based on a verbal descriptive scale, more fentanyl pati ents (38%) experienced moderate pain at discharge than ketorolac (11%; P <.05) or piroxicam (4%; P <.01) patients. The incidence of measured side effects did not differ significantly between groups. Conclusions : Intramuscular ketorolac was associated with shorter recovery room st ays while providing analgesia equal to intravenous fentanyl or the ora l nonsteroidal antiinflammatory drug piroxicam.