Intraoperative ketorolac and eye pain after viteoretinal surgery: a prospective, randomized, placebo-controlled study.
OBJECTIVE
To compare the efficacy of one intraoperative dose of intravenous ketorolac tromethamine to saline placebo in controlling postoperative eye pain, nausea, and sedation following vitreoretinal surgery.


METHODS
Prospective, randomized, placebo-controlled clinical trial.


METHODS
One hundred fourteen vitreoretinal surgical patients were randomized over a 7-month period to a single intraoperative intravenous dose of ketorolac tromethamine or placebo. All patients underwent surgery with intravenous sedation and retrobulbar anesthetic injection and had access to a standard postoperative analgesic regimen. After 2 and 5 hours, eye pain, nausea, and sedation levels were recorded using a standard visual analog scale. Analgesic requirements were tabulated.


RESULTS
Patients given ketorolac were significantly less likely to have postoperative eye pain than were placebo-treated patients (P = 0.0043). Fewer ketorolac patients required postoperative analgesia than placebo patients did (P < 0.0001). Four ketorolac patients (7%) required a narcotic compared to 11 placebo patients (20%) (P < 0.0001). Fewer ketorolac patients experienced nausea and sedation than placebo patients did, but this difference was not statistically significant.


CONCLUSIONS
Ketorolac tromethamine is an effective nonnarcotic choice for postoperative pain control following vitreoretinal surgery. Pain control is particularly important in this group of patients, whose compliance with postoperative procedures and positioning may significantly affect surgical outcome.
Fekrat
Sharon
S
Duke University Eye Center, Duke University Medical Center, Durham, North Carolina, USA.
Marsh
Marta J
MJ
Elsing
Sarah H
SH
Raja
Sharath C
SC
de Juan
Eugene
E
Campochiaro
Peter A
PA
Haller
Julia A
JA
D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005128:Eye Diseases / Q000601:surgery; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007430:Intraoperative Care / Q000379:methods; D020911:Ketorolac Tromethamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000188:drug therapy; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D012164:Retinal Diseases / Q000601:surgery; D012591:Scleral Buckling / Q000009:adverse effects*; D014821:Vitrectomy / Q000009:adverse effects*; D014822:Vitreous Body / Q000601:surgery
D018712:Analgesics, Non-Narcotic; D016861:Cyclooxygenase Inhibitors; D020911:Ketorolac Tromethamine