The efficacy of intravenous ketorolac for pain relief in single-stage adjustable strabismus surgery: a prospective, randomized, placebo-controlled trial

Abstract

Purpose: To determine the efficacy of preoperative intravenous ketorolac in reducing intraoperative and postoperative pain and improving patient satisfaction in patients undergoing single-stage adjustable strabismus surgery.

Methods: A prospective, randomized, placebo-controlled clinical trial was performed with 67 patients who underwent horizontal recti muscle surgery with adjustable sutures. The test group received intravenous ketorolac (60 mg) before surgery, and the control group received intravenous normal saline. Topical 0.5% proparacaine was administered to both groups during surgery. Vital signs including heart rate and blood pressure were recorded every 10 min throughout the surgery. The patients were asked to rate their maximum intraoperative and postoperative pain scores using a numerical pain rating scale. Patient satisfaction was also assessed using a five-point analogue scale.

Results: The ketorolac-premedicated patients had less pain both during and after surgery (P = 0.033 and P = 0.024, respectively). There were no differences in vital signs during surgery and patient satisfaction between the two groups.

Conclusions: Intravenous ketorolac, when administered preoperatively for single-stage adjustable strabismus surgery under topical anaesthesia, was effective in reducing pain during and after surgery.

Figure 1

Comparison of blood pressures between the ketorolac and placebo groups. DBP, diastolic blood pressure; End, parameters measured at the conclusion of surgery; Pre, parameters measured at the beginning of surgery; SBP, systolic blood pressure; 10 min, parameters measured 10 min after initiation of surgery; 20 min, parameters measured 20 min after initiation of surgery.

Figure 2

Comparison of pulse rates between the ketorolac and placebo groups. End, parameters measured at the conclusion of surgery; Pre, parameters measured at the beginning of surgery; 10 min, parameters measured 10 min after initiation of surgery; 20 min, parameters measured 20 min after initiation of surgery.