• A Blackburn, J D Stevens, R G Wheatley, T H Madej, and D Hunter.
• Department of Anaesthesia, York District Hospital, UK.
• J Clin Anesth. 1995 Mar 1; 7 (2): 103-8.

Study ObjectiveTo investigate the efficacy, opioid-sparing effects and any reduction in adverse events of a continuous intravenous (i.v.) infusion of ketorolac following lower abdominal surgery.DesignRandomized, double-blind, placebo-controlled, parallel-group study.SettingInpatient elective gynecologic surgical patients.Patients60 ASA physical status I or II patients aged 18 to 70 years scheduled for elective abdominal hysterectomy.InterventionsFollowing standardized preparation and anesthesia, continuous i.v. infusions of either ketorolac or placebo were administered for 24 hours postoperatively with a patients' standardized postoperative protocol. Supplementary analgesia was administered by an i.v. patient-controlled analgesia (PCA) system.Measurements And Main ResultsA significantly lower proportion of the patients in the ketorolac group (6%) rated their pain at 24 hours as moderate or severe compared with patients in the placebo group (34%) (p = 0.04). Mean 24-hour morphine consumption was significantly lower in the ketorolac group (43 mg; SEM 5 mg) compared with the placebo group (55 mg SEM 5 mg) (p = 0.02). There was no significant difference in the incidence of postoperative hypoxemia between the groups with respect to mean times per hour spent with oxygen saturation (SPO2) less than 85%, more than 85% but less than 90%, or more than 90% but less than 94%, mean hourly SPO2, or the incidence and duration of severe hypoxemic episodes. Nausea and vomiting were the only significant adverse events, and they occurred in 30% of patients in both groups.ConclusionIntravenous infusion of ketorolac combined with morphine delivered via a PCA device would appear to be a valuable method of providing balanced analgesia following lower abdominal surgery.

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