This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chawla, R. Articles by Kumar, M. Search for Related Content PubMed Articles by Chawla, R. Articles by Kumar, M.

SUBCUTANEOUS KETOROLAC FOR POST OPERATIVE PAIN RELIEF

Department of Anaesthesiology & Critical Care, University College Of Medical Sciences & Guru Teg Bahadur Hospital, Dilshad Garden Delhi 110095 (INDIA)

INTRODUCTION: Subcutaneous route of analgesia has several advantages: low dose, less side effects, easy administration, patient safety and clinical effectiveness. This study was conducted to assess the efficacy of s/c infusion of ketorolac for post operative pain relief.

METHODS: The study was approved by institution ethics committee. 60 adult patients (asa i-ii) scheduled for major orthopedic surgery under ga were included. They were premedicated with tab diazepam 10 mg 90 minutes before surgery. Iv ketorolac 30mgs was injected just prior to induction. Ga was induced with sleep dose of inj.thiopentone and intubation after inj.suxamethonium (1.5mg/kg). Anesthesia was maintained with oxygen: nitrous oxide (33:66) vecuronium, halothane(0.5–1%). 3 hours after induction, they were randomly divided into 2 groups. Groupa(n=30) received s/c ketorolac infusion 2mg(in 3ml)/hr and i/m saline (placebo) 1ml every 6 hours for 24 hours. Group b received s/c infusion of saline (placebo) 3ml/hour and i/m ketorolac 30 mg (1ml) every 6 hours. Monitoring was done using propaq 102 el monitor. Pain was assessed using vas, time for first rescue analgesia, 24 hours analgesic requirement.

RESULTS: Vas revealed higher pain scores in group b at 6,12,18,24 hours (p<0.05) (fig 1).20 patients in group a and 22 patients in group b required rescue analgesiawithin 6 hours after surgery. The total dose was 48 mgs in group a and 120 mgs in group b. The cardio-respiratory parameters were comparable.Both s/c infusion and i/m bolus provided effective analgesia.(vas <5). However, the effect was sustained with s/c infusion and intermittent with i/m route.

DISCUSSION: Subcutaneous infusion of analgesics (opioids and non opioids) have been tried for pain relief with encouraging results (1–4) opiates are known to cause respiratory depression. Ketorolac trimethamine, an nsaid has been reported to be safe and effective (1–2).in the present study, ketorolac when given by i/m or s/c infusion produced effective analgesia for post operative pain. However,s/c infusion (48mgs) provided more sustained analgesia than i/m route (120mgs).

REFERENCES:

1 ANAESTH INTENSIVE CARE 2000; 28: 654–659[Medline]

2 POSTGRAD MED J 1994; 70: 359–362[Abstract]

3 J PAIN SYMP MANAG 1999; 18(2): 111–119[Medline]

4 ANN ACAD MED SINGAPORE 1994; 23: 456–9[Medline]

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chawla, R. Articles by Kumar, M. Search for Related Content PubMed Articles by Chawla, R. Articles by Kumar, M.