title: The effect of perioperative ketorolac on pain control in pregnancy termination.
abstract: BACKGROUND
  The study was conducted to evaluate the effect of perioperative ketorolac on pain associated with first-trimester aspiration abortion.
  
  
  METHODS
  A double-blind, randomized, placebo-controlled trial was performed involving pregnant women up to 14 weeks' gestation who desired pregnancy termination. Subjects were randomized to receive ketorolac 30 mg intravenously (n=31) or placebo (n=45) at the time of induction of anesthesia. Postoperative pain was assessed using a visual analog scale (VAS). The primary outcome was pain control as determined by VAS score. Secondary measures of patient use of supplemental postoperative pain medications and patient satisfaction were assessed.
  
  
  RESULTS
  Subjects in the ketorolac group had lower postoperative pain scores on the VAS at all time points compared to the placebo group, but the difference was not statistically significant. The ketorolac group used less postoperative acetaminophen compared to the placebo group (6.5% versus 35.6%), respectively. Subjects in the placebo group and the ketorolac group had similar requirements for postoperative narcotics in the recovery room (22.2% versus 19.4%). Patient satisfaction with pain level was equivalent between the groups at all postoperative end points. There was no observed difference in perioperative blood loss observed between the two groups.
  
  
  CONCLUSIONS
  Perioperative ketorolac has the same effect on postoperative pain as determined by VAS as placebo. The use of ketorolac at the 30-mg dose cannot be recommended for better pain control for patients undergoing first-trimester pregnancy termination by suction curettage. The only positive effect of the use of ketorolac compared to placebo was a reduction in the use of acetaminophen. Ketorolac use does not appear to change blood loss in the operating room or through postoperative day 1 compared to placebo.
authors: Department of Obstetrics and Gynecology, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ 07103, USA. rochene@umdnj.edu
authors: Natalie E
authors: NE
authors: Roche
authors: Dongchen
authors: D
authors: Li
authors: Denise
authors: D
authors: James
authors: Adam
authors: A
authors: Fechner
authors: Vasanti
authors: V
authors: Tilak
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D019990:Perioperative Care; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D020910:Ketorolac