Low-dose intra-articular ketorolac for pain relief following arthroscopy of the knee joint

The systemic administration of nonsteroidal anti-inflammatory agents has be en shown to improve analgesia following arthroscopy of the knee joint. Keto rolac 60 mg, when given intra-articularly, provides better postoperative an algesia than an identical dose administered systemically. We compared the p ostoperative analgesic effect of ketorolac 10 mg given intravenously with 5 mg intra-articularly in 60 patients undergoing arthroscopy of the knee joi nt under general anaesthesia. Patients were randomly allocated in a double- blind manner to receive 0.25% bupivacaine 20 mi and ketorolac 5 mg intra-ar ticularly (n = 27) or intravenous ketorolac 10 mg followed by 0.25% bupivic aine 20 mi (n = 30) at the end of surgery. There were no differences betwee n the groups in terms of their physical characteristics or in the nature of procedure performed. There was no statistical difference between the two g roups in time to first analgesia or postoperative visual analogue pain scor es at 1, 2 and 4 h (p = 0.6). The median consumption of a standard analgesi c was reduced in the intra-articular group in the second 24-h period but th is did not achieve statistical significance (p = 0.08). Only five patients in total needed postoperative morphine. A reduced amount of locally applied ketorolac (5 mg) provides similar analgesia to a higher systemic dose (10 mg) following knee arthroscopy.