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document
Comparison of analgesic effect of locally and systemically administered ketorolac in mastectomy patients . BACKGROUND Ketorolac is a parenteral nonsteroidal antiinflammatory drug ( NSAID ) . Two features have limited its clinical utility : tendency to elicit kidney failure and inability to produce complete analgesia . Because most NSAIDs are weak acids ( pKa 3-5 ) and become concentrated in acidic tissues , such as injured and inflamed tissues , we hypothesized that local administration may enhance its analgesic efficacy while lowering the potential for systemic complications . METHODS We conducted a randomized , placebo-controlled study of 60 group I-II ( American Society of Anesthesiology criteria ) mastectomy patients , 20 in each group . Near the end of surgery and every 6 h postoperatively , 20 ml of the study solution containing normal saline with or without 30 mg of ketorolac were administered simultaneously either via a Jackson-Pratt drain or intravenously in a double-blind fashion . The quality of pain control , the amount and character of the drain fluid , incidence of nausea and vomiting , length of stay in the postoperative care unit , and amount of morphine used for treatment of break-through pain were recorded . RESULTS Intraoperative administration of ketorolac resulted in better quality of pain control in the immediate postoperative period regardless of route of administration . The incidence of nausea was significantly higher in the placebo group , and drain output in the ketorolac groups did not exceed the output in the placebo group . CONCLUSION Analgesic of the locally administered ketorolac is equally effective to the efficacy of ketorolac administered intravenously .
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Intervention_Pharmacological
ketorolac
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Intervention_Pharmacological
Ketorolac
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
normal saline with or without 30 mg of ketorolac
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Intervention_Pharmacological
ketorolac
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Intervention_Pharmacological
ketorolac
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Intervention_Control
placebo
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Intervention_Pharmacological
ketorolac
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Intervention_Pharmacological
ketorolac
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Outcome_Physical
quality of pain control , the amount and character of the drain fluid , incidence of nausea and vomiting ,
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Outcome_Other
length of stay in the postoperative care unit , and amount of morphine
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Outcome_Pain
quality of pain control
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Outcome_Physical
incidence of nausea
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Outcome_Physical
drain output
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Outcome_Other
effective
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Outcome_Other
efficacy