Postoperative effects of fentanyl, ketorolac, and piroxicam as analgesics for outpatient laparoscopic procedures.
OBJECTIVE
To compare postoperative analgesia and side effects of intramuscular ketorolac, intravenous fentanyl, and oral piroxicam on healthy women undergoing laparoscopic surgery.


METHODS
The study was a randomized double-blind clinical trial of three analgesic drugs. An initial 100-micrograms dose of fentanyl was given at induction, with 25-micrograms boluses after 45 and 90 minutes of operating time. Piroxicam, 40 mg, and ketorolac, 60 mg, were administered 90 and 30 minutes before induction, respectively.


RESULTS
Eighty-four subjects were included in the analysis. Ketorolac patients (N = 29) spent significantly less time in the recovery room (median 96 minutes) than those receiving fentanyl (N = 27) (median 121 minutes; P < .01) or piroxicam (N = 28) (median 124 minutes; P < .01) or a verbal descriptive scale, more fentanyl patients (38%) experienced moderate pain at discharge than ketorolac (11%; P < .05) or piroxicam (4%; P < .01) patients. The incidence of measured side effects did not differ significantly between groups.


CONCLUSIONS
Intramuscular ketorolac was associated with shorter recovery room stays while providing analgesia equal to intravenous fentanyl or the oral nonsteroidal antiinflammatory drug piroxicam.
Lysak
S Z
SZ
Department of Anesthesiology, Greenville Hospital System, South Carolina.
Anderson
P T
PT
Carithers
R A
RA
DeVane
G G
GG
Smith
M L
ML
Bates
G W
GW
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000700:Analgesics; D000762:Anesthesia Recovery Period; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D020910:Ketorolac; D010535:Laparoscopy; D010149:Postoperative Pain / Q000188:drug therapy*; D010894:Piroxicam / Q000009:adverse effects; D014046:Tolmetin / Q000009:adverse effects / Q000031:analogs & derivatives*
D000700:Analgesics; D010894:Piroxicam; D014046:Tolmetin; D005283:Fentanyl; D020910:Ketorolac