A COMPARISON OF ORAL KETOROLAC AND HYDROCODONE-ACETAMINOPHEN FOR ANALGESIA AFTER AMBULATORY SURGERY - ARTHROSCOPY VERSUS LAPAROSCOPIC TUBAL-LIGATION

This multicenter study compared the analgesic efficacy and side effect s of ketorolac and hydrocodone-acetaminophen when administered orally after ambulatory arthroscopic or laparoscopic tubal ligation procedure s. After awakening from general anesthesia, 252 patients experiencing moderate or severe postopera tive pain were randomly assigned to recei ve one of three analgesic treatments according to a placebo-controlled , double-blind protocol. Group 1 (n = 83) received oral ketorolac 10 m g every 6 h for up to 3 days, Group 2 (n = 82) received hydrocodone 7. 5 mg plus acetaminophen 750 mg every 6 h for up to 3 days, and Group 3 (n = 87) received placebo capsules followed by ketorolac 10 mg every 6 h for up to 3 days. Severity of pain was recorded using a 4-point ca tegorical score and visual analog scale (VAS) at 0.5 h and subsequentl y at hourly intervals for 6 h, as well as daily for up to 3 days. Pain relief was recorded using a 5-point categorical scale at the same tim e paints. In the patients undergoing arthroscopic surgery, both ketoro lac and hydromorphone-acetaminophen provided superior pain relief comp ared with the placebo. Although the categorical summed pain intensity difference (SPID), VAS SPID, and total pain relief scores were higher in the ketorolac group compared with the hydrocodone-acetaminophen gro up, the differences were not statistically significant. In the patient s undergoing laparoscopic tubal ligation surgery, the three treatment groups displayed similar responses to the study medications. However, the ketorolac group scored higher in terms of overall tolerability tha n the hydrocodone-acetaminophen group. In conclusion, there was no dif ference in the efficacy between oral ketorolac and hydrocodone-acetami nophen combination in controlling pain after outpatient arthroscopic s urgery procedures. Neither oral analgesic proved to be very effective after laparoscopic tubal ligation.