• R S Twersky, A Lebovits, C Williams, and T R Sexton.
• Department of Anesthesiology, State University of New York at Brooklyn, USA.
• Clin J Pain. 1995 Jun 1; 11 (2): 127-33.

ObjectiveThe purpose of this study was to compare the efficacy and safety of i.v. ketorolac and fentanyl for moderate to severe postoperative pain in patients undergoing elective surgery in an ambulatory surgery unit.DesignA double-blind randomized trial.SettingAn ambulatory surgery unit in a university-affiliated hospital.PatientsSixty-nine patients undergoing elective laparoscopy, inguinal hernia repair, or knee arthroscopy were enrolled.InterventionPatients were randomly assigned to receive intravenous ketorolac 30 mg (n = 38) or fentanyl 50 micrograms (n = 31) for moderate to severe postoperative pain.Outcome MeasuresPain, assessed using a 100-mm visual analog scale and a 5-point verbal pain scale; adverse effects, as well as vital signs were recorded every 15 min for 150 min or until discharge from the postanesthesia care unit, 6 and 24 h after discharge.ResultsPain reduction on both visual analog and verbal scales was significantly greater with fentanyl than ketorolac at 15 min. In addition, the proportion of patients requiring remedication at the 15-min time point was significantly greater in the ketorolac group. However, there were no significant differences between fentanyl and ketorolac between 30 and 150 min after surgery. Notably, pain reduction was significantly greater with ketorolac on the verbal scale at the 6 h measurement.ConclusionsKetorolac appears not be as effective as fentanyl in treating early postoperative pain. Although fentanyl still appears to be the drug of choice in the early postoperative period, the parenteral use of ketorolac was more effective during the later postoperative period in providing longer lasting analgesia.

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