Ketorolac improves recovery after outpatient anorectal surgery

PURPOSE: The purpose of this study was to evaluate the effectiveness of ket orolac combined with local anesthetics for anorectal surgery. METHODS: From June 1998 through March 1999, 123 outpatients undergoing anorectal surgery were entered into a prospective, randomized, double-blinded study involvin g three treatment groups. All patients received intravenous sedation consis ting of fentanyl and a propofol infusion, with a local anesthesia mixture o f lidocaine, bupivacaine, and bicarbonate. Group A (41 patients) received p lacebo (saline) injections. Group B (41 patients) received 60 mg of intrave nous ketorolac at the onset of the procedure, and Group C (41 patients) rec eived 60 mg of ketorolac mixed with the local anesthetic. Data were analyze d using analysis of variance and chi-squared tests. RESULTS: All groups had similar demographic characteristics and operative procedures. Twenty-nine of the 123 patients were human immunodeficiency virus-positive. There was n o difference in operative or anesthesia time. Anesthesia and fluids given w ere similar in across groups. A significantly higher percentage of Group A patients had pain (34 percent) and required additional oral analgesia (20 p ercent) in the Day Surgery Unit. Only 5 percent of Group B and Group C pati ents complained of pain, with oral analgesics given to 2 percent of Group B and none in Group C. Voiding difficulties were more common in Group A pati ents, one patient requiring catheterization CONCLUSION: The addition of ket orolac (60 mg), either intravenous or injected with local anesthetics, redu ces voiding problems and significantly decreases postoperative analgesic re quirements in outpatients undergoing anorectal surgery.