British Journal of Anaesthesia, Vol 75, Issue 1 15-18, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia
J. E. Rogers, B. G. Fleming, K. C. Macintosh, B. Johnston and J. O. Morgan-Hughes
In order to investigate the analgesic effect of timing of administration of
ketorolac 10 mg i.v., we recorded patient-controlled use of diamorphine at
2, 4 and 12 h after abdominal hysterectomy. In a randomized, double-blind
trial, 30 patients received ketorolac before skin incision and 28 after
skin closure. A control group of 32 patients did not receive ketorolac. We
measured operative blood loss and assessed nausea, vomiting and pruritus.
After 2 h of patient-controlled analgesia, the median cumulative
diamorphine dose in the group given ketorolac before operation was less
than that of the control group (95% confidence interval 8-66 micrograms
kg-1; P = 0.01). There were no other statistically significant differences
in diamorphine consumption between the groups. The frequency of nausea and
vomiting was similar in all groups Median blood loss in the group given
ketorolac before operation exceeded that of the patients who did not
receive ketorolac before operation (95% confidence interval 20-149 ml; P =
0.01). We conclude that the diamorphine-sparing effect of ketorolac
attributable to timing of administration was small, conferred no clinical
benefit and was accompanied by increased bleeding. No patient given
ketorolac complained of pruritus.
CLINICAL INVESTIGATIONS
Effect of timing of ketorolac administration on patient-controlled opioid use
Department of Anaesthesia, Norfolk and Norwich Hospital, Brunswick Road, Norwich NR1 3SR
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