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A prospective randomized trial of intravenous ketorolac vs acetaminophen administered with opioid patient-controlled analgesia in gynecologic surgery

Gynecologic Oncology Dec 13, 2019

Rakowski JA, Holloway RW, Ahmad S, et al. - Researchers compared the efficacy of two non-narcotic analgesics [acetaminophen (Ofirmev) vs ketorolac (Toradol)] in providing postoperative pain control on combining with opioid patient-controlled analgesia (PCA) pump. Further, they performed comparisons of the rates of ileus, postoperative bleeding, transfusions, and length-of-hospitalization (LOH). In this randomized trial, patients undergoing benign or malignant gynecologic laparotomy procedures were provided either acetaminophen (A) 1-g intravenous (IV) every 6-h or ketorolac (K) 15-mg IV every 6-h from postoperative day 1–3 in addition to an opioid PCA. They assessed 100 patients who underwent 55 benign gynecologic laparotomies and 45 cancer-related laparotomies. Outcomes revealed similar efficacy of ketorolac and acetaminophen in providing postoperative analgesia. Reduced dilaudid usage and improved return to flatus time were reported in relation to receipt of Ketorolac. Rates of transfusion were similar among patients receiving ketorolac vs acetaminophen. Relative to patients receiving acetaminophen, those received ketorolac had improved return of bowel function compared with acetaminophen.
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