COMPARISON OF ORAL KETOROLAC AND HYDROCODONE FOR PAIN RELIEF AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

The analgesic effectiveness of ketorolac tromethamine was compared wit h hydrocodone and acetaminophen for pain from an arthroscopically assi sted patellar-tendon autograft anterior cruciate ligament reconstructi on. There were 125 patients evaluated in a double-blind, randomized, m ulticenter, and multidose study. A loading dose of parental ketorolac tromethamine was administered and subjects were later given two staged doses of the same ''unknown'' drug with pain evaluations conducted af ter each dose. For group I, dose 1 consisted of ketorolac tromethamine 20 mg orally and dose 2 was ketorolac tromethamine 10 mg. For group 2 , both dose 1 and dose 2 consisted of hydrocodone 10 mg plus acetamino phen 1,000 mg orally. Efficacy was evaluated by standard analgesic mea sures. Subjects treated as outpatients showed lower categorical pain i ntensity for ketorolac tromethamine than hydrocodone and acetaminophen at 1 hour (P = .03), 2 hours (P = .006), and 3 hours (P = .02); lower summed intensity differences for ketorolac tromethamine than hydrocod one and acetaminophen at 3 hours (P = .014) and 4 hours (P = .019); an d better total pain relief for ketorolac tromethamine than hydrocodone and acetaminophen at 3 hours (P = .014) and 4 hours (P= .013). With a n effective loading dose administered before the subsequent oral dosag e, there was statistically better pain reduction with ketorolac tromet hamine than with hydrocodone and acetaminophen. Moreover, ketorolac tr omethamine was no more likely to cause digestive complaints than hydro codone and acetaminophen. No bleeding problems were observed in either group. In the outpatient setting, ketorolac tromethamine controls pos toperative pain better than hydrocodone and acetaminophen in the immed iate postsurgery period.