Indomethacin and ketorolac given preoperatively are equally effective in reducing early postoperative pain after laparoscopic cholecystectomy

Allan Forse, MD;* Hossam El-Beheiry, MD;**; Patrick O. Butler, MD, FRCSC**; Ronald F. Pace, MD, FRCSC#

Canadian Journal of Surgery 1996; 39: 26-30

From the *Department of Surgery and the **Department of Anesthesia, Queen's University, Kingston, Ont., and the #Department of Surgery, Kitchener-Waterloo Hospital, Kitchener, Ont.

Paper reprints of the full text may be obtained from: Dr. Ronald Pace, 749 King St. W, Kitchener ON N2G 1E4
See also:
Effect of pH modification by bicarbonate on pain after subcutaneous lidocaine injection

Abstract

Objective: To evaluate the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) on pain after laparoscopic cholecystectomy.
Design: A prospective, randomized, placebo-controlled, double-blind study.
Setting: A university hospital.
Patients: Fifty-two patients with cholelithiasis but without known allergy to one of the study drugs, history of bleeding, peptic ulcer disease, known cardiac, lung or renal disease, abnormal liver function or use of opiates or NSAIDs within 2 weeks before operation. Patients were assigned to one of three groups, and treatment was randomized by placing the drugs in sealed, numbered envelopes.
Intervention: Administration of the NSAIDs ketorolac, intramuscularly, or indomethacin, rectally, before laparoscopic cholecystectomy.
Main Outcome Measures: Postoperative pain scored on a visual analogue scale and by nurse assessment, total dose of fentanyl citrate given, and nausea or emesis.
Results: Patients in the placebo group reported significantly more pain than either NSAID group (p <0.05) and were reported as having significantly more pain by the nurses (p <0.05). These patients were subsequently treated with a higher mean postoperative dose of fentanyl citrate than either NSAID group (p <0.05). Furthermore, the placebo group reported more nausea and emesis (p <0.05). There was no significant difference in any of the parameters measured between the ketorolac or indomethacin group.
Conclusions: The data demonstrate that the NSAIDs ketolorac and indomethacin, administered preoperatively, decrease early postoperative pain and nausea after laparoscopic cholecystectomy and are equally efficacious in producing these results.
GO TO CJS:Feb. 1996 - GO TO Surgery and orthopedics
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