Prospective double-blind study of effect of ketorolac administration afterlaparoscopic urologic surgery

Background and Purpose: To decrease postoperative dependence on narcotics f or analgesia, we have evaluated ketorolac as an adjunct to perioperative pa in control in patients undergoing laparoscopic urologic surgery. Patients and Methods: Sixty-five patients (34 male, 31 female) were randomi zed to receive either ketorolac tromethamine (15-30 mg IV q 6 h) or placebo prior to laparoscopic surgery. Patient-controlled analgesia in the form of morphine sulfate was provided. Operative factors such as the type of surge ry, operative time, and estimated blood loss were recorded. Postoperative f actors such as analog pain score (range 0-10), narcotic usage, and length o f stay were evaluated. Results: Fifty-five patients completed the study. The average pain score wa s 2.2 and 4.5 for the ketorolac and placebo groups, respectively (P < 0.005 ). The mean amounts of total morphine used were 39.2 mg (ketorolac) and 62. 5 mg (placebo) (P = 0.077). The length of stay was not significantly differ ent in the ketorolac (2.5 days) and placebo (2.6 days) groups (P = 0.74). O perative times (P = 0.21) and estimated blood loss (P = 0.60) were not sign ificantly different in the two groups, Ketorolac did not adversely affect r enal function; serum creatinine changes were not significantly different fr om those in the patients receiving placebo (P = 0.50). Laparoscopic pyelopl asty necessitated more narcotic analgesia than did other laparoscopic proce dures (P = 0.05). Conclusion: Ketorolac decreases the subjective perception of pain after lap aroscopic urologic surgery. It is suggested that ketorolac administration d ecreases the amount of narcotic usage as well. Time to resumption of oral i ntake and length of hospital stay were not influenced by use of ketorolac.