Effect of Ketorolac on Pain Scores and Length of Stay in Post Anaesthetic Care Unit after Major Abdominal Surgery

Abstract

Background: To find out the effectiveness of ketorolac
administered at the end of surgery in reducing pain scores
and the length of stay in the Post Anaesthetic Care Unit
(PACU) for the patients undergoing major abdominal
surgery.
Methods: This interventional study, a double blind
randomized control trial was conducted at POF Hospital,
Wah Cantt, over a three year period starting 2004. One
hundred adult patients, planned for major surgery
fulfilling the inclusion criteria were randomized by simple
random numbers table into two groups by codes. At the
end of procedure, 30mg ketorolac (an NSAID) was given
intravenously to every member of ketorolac group and 10
ml normal saline I/V (placebo) was given to every member
in control group. All the patients were shifted
to PACU. The doctor in charge PACU had to decide the
length of stay based on two parameters; 1) Pain score on
the basis of visual analogue score (VAS) and 2) Salim ABC
score for recovery room stay.
Results: The initial mean post operative scores in the
PACU were lower for ketorolac group, 3.6 on Visual
analogue score(VAS) with a standard deviation (S.D.)
of +/-0.9, and for control group the respective mean
postoperative pain score was 5.4 with the S.D. of +/-1.3.
This difference was of statistical significance with a
p value of less than 0.05. The mean length of stay
in PACU for ketorolac group was 97 minutes with an
S.D. of +/-30 minutes, while the corresponding mean
and S.D. for the control group were 134 minutes
and +/-35 minutes respectively which also depicted
a difference of statistical significance with a p value of
less than 0.05.
Conclusion: Ketorolac administered I/V at the end of
surgery effectively controls the immediate post operative
pain and reduces the length of stay in PACU.