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Comparative Effects of Ketorolac, Dezocine, and Fentanyl as Adjuvants During Outpatient Anesthesia

Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas; and Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri

The comparative effects of ketorolac, dezocine, and fentanyl were evaluated in 136 healthy female patients undergoing outpatient laparoscopic procedures according to a randomized, double-blind protocol. Patients received ketorolac (60 mg) or dezocine (6 mg) or fentanyl (100 µg, control group) before the start of the operation. A standardized general anesthetic technique consisting of midazolam (2 mg), fentanyl (50 µg), and propofol (2 mg/kg) for induction of anesthesia followed by propofol (120 µg.kg^–1·min^–1), vecuronium (1–2 mg), and 67% nitrous oxide in oxygen for maintenance of anesthesia, was used. In the postanesthesia care unit, 61% of patients in the fentanyl group received analgesic drugs for persistent pain, compared with 34% and 25% in the ketorolac and dezocine groups, respectively. Similarly, less postoperative fentanyl (mean±SD) was required in the ketorolac (22±33 µg) and dezocine (18±35 µg) groups, compared with the fentanyl (58±71 µg) group. However, 52% of the patients receiving dezocine required antinausea therapy in the postanesthesia care unit, compared with 20% and 18% in the fentanyl and ketorolac groups, respectively. Finally, recovery times were significantly shorter in the ketorolac (vs dezocine) group. Although both ketorolac and dezocine were effective alternatives to fentanyl when administered during outpatient laparoscopy, dezocine was associated with an increased incidence of postoperative nausea and a delayed discharge time compared with ketorolac.

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