Pf. White et al., A COMPARISON OF ORAL KETOROLAC AND HYDROCODONE-ACETAMINOPHEN FOR ANALGESIA AFTER AMBULATORY SURGERY - ARTHROSCOPY VERSUS LAPAROSCOPIC TUBAL-LIGATION, Anesthesia and analgesia, 85(1), 1997, pp. 37-43
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.