This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by G. Pavy, T. J. Articles by Evans, PhD, S. F. Search for Related Content PubMed PubMed Citation Articles by G. Pavy, T. J. Articles by Evans, PhD, S. F.

---

OBSTETRIC ANESTHESIA

The Effect of Intravenous Ketorolac on Opioid Requirement and Pain After Cesarean Delivery

Department of Anaesthesia and Women and Infants Research Foundation, King Edward Memorial Hospital for Women, Subiaco 6008, Western Australia, Australia

Address correspondence and reprint requests to Dr. T. Pavy, Head, Department of Anaesthesia, King Edward Memorial Hospital for Women, 374 Bagot Rd, Subiaco 6008, Western Australia, Australia.

Nonsteroidal antiinflammatory drugs, including ketorolac, are widely used for postoperative analgesia. This randomized, double-blinded trial compared IV ketorolac or saline combined with meperidine patient-controlled epidural analgesia (PCEA) after cesarean delivery.

Fifty healthy parturients scheduled for elective cesarean delivery under combined spinal-epidural anesthesia received PCEA plus either IV ketorolac (Group K) or saline (Group C) for 24 h. The ketorolac dose was modified, after six patients had been studied, based on new product information recommending a maximum of 120 mg ketorolac over 24 h. Group K (n = 24) and Group C (n = 20) were demographically similar. During the first 24 h, Group K used significantly less meperidine (P < 0.05). Postoperative pain at rest and with movement, and patient satisfaction, did not differ significantly between groups, except that worst pain at 12 h was less in Group K (P < 0.005). The two groups were similar with respect to patient recovery and side effects. IV ketorolac, as an adjunct to PCEA after cesarean delivery, produced a meperidine dose-sparing effect of approximately 30%, but did not significantly improve pain relief, reduce opioid-related side effects, or change patient outcome.

This article has been cited by other articles:

				M F Khan, O B Omole, and G J O Marincowitz Postoperative analgesia following caesarean deliveries in a rural health district of South Africa Trop Doct, October 1, 2009; 39(4): 217 - 221. [Abstract] [Full Text] [PDF]

				B. Carvalho, L. Chu, A. Fuller, S. E. Cohen, and E. T. Riley Valdecoxib for postoperative pain management after cesarean delivery: a randomized, double-blind, placebo-controlled study. Anesth. Analg., September 1, 2006; 103(3): 664 - 670. [Abstract] [Full Text] [PDF]

				S.-Y. Liu, J.-P. Shieh, J.-I. Tzeng, H. Chia-Hui, Y.-L. Cheng, K.-L. Huang, and J.-J. Wang Novel Depots of Ketorolac Esters Have Long-Acting Antinociceptive and Antiinflammatory Effects Anesth. Analg., September 1, 2005; 101(3): 785 - 792. [Abstract] [Full Text] [PDF]

				A. Ng, A. Temple, G. Smith, and J. Emembolu Early analgesic effects of parecoxib versus ketorolac following laparoscopic sterilization: a randomized controlled trial{dagger} Br. J. Anaesth., June 1, 2004; 92(6): 846 - 849. [Abstract] [Full Text] [PDF]

				P. J. S. Koo Acute Pain Management Journal of Pharmacy Practice, August 1, 2003; 16(4): 231 - 248. [Abstract] [PDF]