KETOROLAC TROMETHAMINE VERSUS PLACEBO AFTER CESAREAN SECTION TO REDUCE PAIN AND NARCOTIC USAGE

J. Lowder, MD, T. Beste, MD

   Objective: To determine if post-cesarean section administration of ketorolac tromethamine reduces pain and narcotic usage.

   Materials and Methods: A double blind, randomized, controlled trial of ketorolac tromethamine versus placebo in post-cesarean section using random allocation was performed after IRB and FDA approval. Patients were randomly assigned to receive either ketorolac tromethamine or placebo. PCA was used for pain control. Visual analog scales (VAS) were administered at 2, 3, 4, 6, 12 and 24-hours to assess pain levels. ANOVA was performed on the VAS using Wilks Multivariate criterion. A T-test was used to evaluate the PCA morphine equivalents and a Mann-Whitney test was used to evaluate the number of PCA attempts.

   Results: 22 patients were in each arm with a total of 44 patients. There was no significant difference between age, gestation, parity, BMI, blood loss, and type of anesthesia. At each hour, there was a lower mean pain score, and ANOVA of VAS at all hours was statistically significant (p=0.033).
PCA data is presented in table 1.
                         Table 1.
                     MSO4 equivalents PCA attempts
Ketorolac     28.1 +/- 3.35 39.6 +/- 9.06
Placebo        41.6 +/- 4.25 60.5 +/- 13.8
P value         p = 0.008 p = 0.081

   Conclusions: Ketorolac tromethamine is efficacious in reducing postoperative pain and narcotics usage after cesarean section.

   Key Words: Ketorolac, postoperative pain cesarean section.