A Comparison between Intravenous Fentanyl Alone and Intravenous Fentanyl plus Intravenous Ketorolac for Late Intraoperative and Immediate Postoperative Analgesia during Laparoscopic Cholecystectomy Authors

Objective: Our study compared the effect of fentanyl alone with fentanyl plus intravenous ketorolac for analgesic efficacy, opioid sparing effects, and opioid-related side effects after laparoscopic cholecystectomy. Materials and Methods: Sixty patients undergoing laparoscopic cholecystectomy were randomized into two groups. Both groups received fentanyl during induction. First group of patients received IV placebo before the end of surgery while second group received 0.5mg of I.V. ketorolac just before the end of surgery. The postoperative pain relief was evaluated by a visual analog scale (VAS) using a 100-mm visual analog scale adverse effects, as well as vital signs were recorded every 15 min for 150 min or until discharge from the postanesthesia care unit. Results: The mean VAS score in first and second hour after surgery was less in the group receiving I.V. ketorolac (3.4 0.2 vs5.4±0.5./ 3.3±0.4 vs4.7 ±0.2.); the rescue analgesia consumption over first 24 h was also less in the group receiving I.V. ketorolac (40±25.9 vs. 102±20.7). The time requirement of first dose of rescue analgesic in the postoperative period was also significantly prolonged in the group receiving I.V. ketorolac (240±24.9 vs. 55±12.3). There was no difference in the sedation scores and in the incidence of PONV in the two groups. Conclusion: The study demonstrates the usefulness of intravenous ketorolac as supplementary analgesic in the treatment of postoperative pain after laparoscopic cholecystectomy.