THE INFLUENCE OF TIMING OF KETOROLAC ADMINISTRATION ON POSTOPERATIVE ANALGESIC REQUIREMENTS FOLLOWING TOTAL ABDOMINAL HYSTERECTOMY

One hundred and thirty-seven patients were studied to assess whether t he timing of a dose of ketorolac affected cumulative morphine requirem ents during the first 12 post-operative hours. Pain, sedation and naus ea scores, respiratory rate and degree of operative blood loss were al so recorded. Thirty-six patients (group A) were given placebo injectio ns pre- and intra-operatively. Thirty-one patients (group B) received placebo pre-operatively and ketorolac 30 mg intra-operatively. Thirty- six patients (group C) received ketorolac 10 mg pre-operatively and ke torolac 20 mg intra-operatively and thirty-four patients (group D) wer e given ketorolac 30 mg pre-operatively and placebo intra-operatively. Post-operative analgesia was with intravenous (i.v.) morphine adminis tered using a patient controlled analgesia (PCA) device. Analysis of v ariance revealed a significant difference in morphine consumption at 1 , 2, 4, 8 and 12 h post-operatively (P<0.05) between group A (no ketor olac) and groups B, C and D (ketorolac). However, there were no signif icant differences between groups B, C and D during the study period. T hus, the timing of ketorolac administration made no difference to over all morphine consumption. Pain, nausea, sedation and respiratory rate scores were similar in all four groups. There was a significantly grea ter blood loss in patients receiving ketorolac (groups B, C and D) com pared with those receiving placebo alone (group A).