Efficacy and Safety of Intravenous Ketorolac versus Nalbuphine in Relieving Postoperative Pain after Tonsillectomy in Children

Abstract

BACKGROUND: Pain is a major postoperative complication worldwide, which in turn impairs normal body performance and increases postoperative morbidity, hospitalisation, and the susceptibility to infections which also lead to chronic pain development.
 AIM: The purpose of this study was to evaluate the efficacy of intravenous ketorolac versus nalbuphine as analgesia after adenotonsillectomy surgery to determine the optimal procedure for pain control and postoperative reduction of analgesic use.
 METHODS: A group of 100 pediatric patients undergoing tonsillectomy or adenotonsillectomy were assigned as follows to two equal groups: Group A: 50 patients received intravenous ketorolac 0.9 mg/Kg. Group B: 50 patients received intravenous nalbuphine 0.25 mg/Kg.
 RESULTS: FLACC (Face, Legs, Activity, Cry, Consolability) pain score was measured after recovery from anaesthesia (postoperative). There was a statistically significant difference concerning pain score between group ‘A’ and group ‘B’ as pain score in 'A' (ranging from 3.18 ± 0.87 to 4.68 ± 0.74) is lower compared to 'B' (ranging from 3.90 ± 0.76 to 5.54 ± 0.73) and probability value < 0.05 except at 90 & 120 min which was observed statistically insignificant. There was no serious postoperative complication detected in either group.
 CONCLUSION: It is concluded that intravenous ketorolac is more effective than intravenous nalbuphine in reducing pain intensity and postoperative analgesic requirements after adenotonsillectomy in children.

Comparison of propofol-nalbuphine and propofol-fentanyl sedation for patients undergoing endoscopic retrograde cholangiopancreatography: a double-blind, randomized controlled trial

“…Nalbuphine is a potentanalgesic agent that is similar to morphine [27,28]. Studies have shown that nalbuphineis widely used in pain management during the perioperative period [29,33,34,35]. Our results showed that nalbuphine was as effective as fentanyl in reducing pain-induced patient movement, and there was no difference in dosage.…”

A scoping review of randomized clinical trials for pain management in pediatric tonsillectomy and adenotonsillectomy

“…A total of 189 randomized controlled and comparison trials met the inclusion criteria for analysis 18–206 . A PRISMA diagram outlining the literature search is shown in Figure 1, and the risk of bias graph is shown in Figure 2.…”

“…A total of 189 randomized controlled and comparison trials met the inclusion criteria for analysis. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ...…”

Luaran Terapi Berdasarkan Jenis Pemberian Analgetik pada Pasien Pasca Operasi Ortopedi

“…Ketorolak diketahui dapat menurunkan nyeri pasca operasi dan menunjukkan insidensi sedasi yang lebih rendah dibandingkan dengan petidin [14][15][16] . Berdasarkan penelitian, efek analgetik ketorolak lebih baik dibandingkan dengan tramadol dan nalbupin 17,18 . Nalbupin diketahui lebih efektif dibandingkan tramadol, namun tidak lebih efektif dibandingkan fentanil 19,20 .…”