Effect of short-term ketorolac infusion on recovery following laparoscopic day surgery

This study tested the hypothesis that, by the addition of parenteral ketorolac to an oral analgesic regimen for one day following laparoscopic surgery, analgesia would be improved and thus the return of normal function hastened. Seventy-two female patients were randomly assigned to receive ketorolac 10.5 mg subcutaneously at the end of surgery followed by a subcutaneous infusion of 1.75 mg/h for 24 to 36 hours, or an equivalent volume of saline. All patients were provided with codeine tablets (30 mg) for analgesia if required. For the first four postoperative days patients recorded details of pain, side-effects and discomfort on performing everyday activities. Patients who received ketorolac received significantly less fentanyl in the Recovery Ward and significantly less codeine prior to discharge than the saline group. They also took significantly fewer codeine tablets over the four-day postoperative period. Pain scores in the ketorolac group were not significantly lower than in the saline group on the first postoperative day (P=0.052) and subsequently remained similar. Levels of discomfort on performing six common activities were similar in the two groups over the four-day postoperative period. We conclude that, despite beneficial effects during the period of ketorolac administration, there was no continuing benefit after this time other than reduced analgesic use, and no improvement in the patients' ability to perform common activities.