Comparison of Postoperative Pain With Preemptive Administration of Intravenous Ketorolac Versus Oral Ibuprofen in Patients Undergoing Interval Laparoscopic Bilateral Tubal Sterilization

摘要

A major goal of anesthesia practitioners is to provide a comfortable and expedient recovery from the effects of surgery and anesthesia. This includes the challenge fostered by managed-care of facilitating earlier discharges while also managing postoperative pain. Moreover, consumer knowledge and technological advances are pressing the health care community to seek higher levels of patient satisfaction and cost containment. Elective surgery patients are acquiring greater expectations regarding the perioperative care they receive, which includes absence of recall, minimal pain or discomfort, and absence of nausea following surgery. Each year over 10 million women in the United States alone elect to have surgical sterilization. This is usually accomplished laparoscopically despite the problems of post- laparoscopic pain, which can be severe enough to warrant an unplanned admission. Anesthesia researchers have sought pharmacologic methods in order to address this challenge, with a contemporary approach being preemptive analgesia. Non-steroidal anti- inflammatory drugs have been shown to inhibit the release of chemical mediators of pain and inflammation following tissue trauma. This results in the reduction of untoward physiologic and psychological effects, improved patient outcomes, and diminishes the economic effects secondary to unplanned hospital admissions. Ketorolac and ibuprofen have both been studied in this patient population when given preemptively with mixed results; presently there is no conclusive evidence as to which drug is more effective. This prospective, randomized, double-blind clinical trial.