Comparison of the analgesic and emetic properties of ketorolac and morphine for paediatric outpatient strabismus surgery

Abstract

In a prospective, double-blind, randomized study, we have compared i.v. ketorolac and morphine in paediatric outpatients undergoing strabismus surgery. Forty-two ASA I or II children, aged 2-12 yr, were allocated randomly to receive either ketorolac 0.75 mg kg-1 i.v. or morphine 0.1 mg kg-1 i.v. and metoclopramide 0.15 mg kg-1. Anaesthesia was induced with propofol and maintained with propofol and nitrous oxide. Pain was assessed at 15-min intervals until discharge, and the incidence of nausea and vomiting was recorded for the first 24 h. There was no difference in pain behaviour scores or recovery times. The incidence of nausea and vomiting during the first 24 h was 19% in the ketorolac group and 71% in the morphine group (P < 0.001). We concluded that ketorolac was an effective analgesic for this type of surgery and that it was associated with less postoperative emesis than morphine and metoclopramide.

The influence of residual neuromuscular block on the incidence of critical respiratory events. A randomised, prospective, placebo-controlled trial

“…Opioids, which provide effective analgesia, may also induce nausea and vomiting themselves and delay recovery due to the excessive sedation that they may cause. 15,16 NSAIDs have been reported to be effective in postoperative analgesia treatment after strabismus surgery, especially when administered by the intravenous route. 3,15,[17][18][19] Their associated sideeffects, such as increased bleeding, nausea and epigastric dyspepsia, may not be critical but are nevertheless undesirable following strabismus surgery.…”

Cost effectiveness analysis of intravenous ketorolac and morphine for treating pain after limb injury: double blind randomised controlled trial

“…Firstly, it compares intravenous ketorolac and intravenous morphine in a nurse controlled, analgesic regimen with titrations according to the individual patients' needs. None of the many other studies that have compared parenteral ketorolac with parenteral opiates in a variety of settings 7 – 10 13 15 – 20 30 – 41 has compared one drug with the other as in this protocol. Secondly, the two drugs were studied within the context of an emergency department.…”

“…The few controlled trials comparing doses of intravenous ketorolac and intravenous morphine were all either perioperative studies or associated with cancer. 8 9 13 – 20…”

Anesthetic techniques and postoperative emesis in pediatric strabismus surgery

“…[1][2][3][4][5] Traditionally, opiates have been used for perioperative analgesia; however, a marked decrease in postoperative emesis occurs when opiates are avoided [6][7][8][9] during surgery.…”