Ketorolac as a pre-emptive analgesic in retinal detachment surgery: A prospective, randomized clinical trial

Abstract

Objective: Retinal detachment surgery is associated with a high incidence of post-operative pain, nausea and vomiting. Previous studies demonstrated a beneficial role of pre-emptive analgesia using regional anesthetic blocks for this type of surgery. The aim of the present study was to evaluate the pre-emptive analgesic effect of ketorolac in patients undergoing retinal detachment surgery under general anesthesia. Methods: With the approval of the Institutional Ethics Committee and written informed consent, 60 adult patients were randomized prospectively, in a double-masked manner, to receive intravenously either ketorolac 30 mg or saline placebo 30 min before operation. Pain scores at 2, 6, 12, 18 and 24 h after surgery, the number of patients requiring post-operative analgesia, total consumption of analgesics, the incidence of oculocardiac reflex as well as the incidence and severity of post-operative nausea and vomiting were recorded. Results: The ketorolac group required post-operative analgesia less frequently than the placebo group (p < 0.0001). The ketorolac group had significantly lower pain scores at all measurement time points (p < 0.001) and lower intra- and post-operative total consumption of analgesics (p < 0.01). The incidence and severity of nausea and vomiting were lower in patients given ketorolac when compared with placebo-treated patients (p < 0.05). The incidence of oculocardiac reflex was not significantly different between groups (p = 0.14). Conclusions: The use of ketorolac for pre-emptive analgesia is effective in patients undergoing retinal detachment surgery under general anesthesia. ©2007 Dustri-Verlag Dr. K. Feistle.