The Combination of Ketorolac with Local Anesthesia for Pain Control in Day Care Retinal Detachment Surgery: A Randomized Controlled Trial

Abstract

This study aims to evaluate the efficacy of ketorolac with local anesthesia compared to local anesthesia alone for perioperative pain control in day care retinal detachment surgery. The randomized controlled trial included 59 eyes of 59 participants for retinal detachment surgery who were randomly assigned (1 : 1) into the ketorolac (K) group and control (C) group. All participants underwent conventional local anesthesia while patients in the K group received an extra administration of preoperative ketorolac. Participants in the K group had a statistically significantly lower intraoperative NRS score (median 1.0 versus 3.0, P = 0.003), lower postoperative NRS score (median 0 versus 1.0, P = 0.035), fewer proportion of rescue analgesic requirement (10% versus 34.5%, P = 0.023), and lower incidence of postoperative nausea and vomiting (13.3% versus 41.4%, P = 0.015) compared to the C group. Intraocular pressure (IOP) changes (△IOP) were significantly reduced in the K group (median 1.9 versus 3.0, P = 0.038) compared to the C group 24 hours postoperatively. In conclusion, the combination of local anesthesia with ketorolac provides better pain control in retinal detachment surgery compared to local anesthesia alone. The beneficial effect of ketorolac with local anesthesia may contribute to a wider-spread adoption of day care retinal detachment surgery. This trial is registered with ClinicalTrials.gov NCT02729285.

Postoperative Pain Management in Vitreoretinal Surgery for Retinal Detachment: A Systematic Review of Randomized Controlled Trials

“…The final screening completed before submission in September 2017 yielded 118 articles after removal of duplicates, with only 8 articles selected for full-text review. Excluded were 6 studies published in 2017 [46][47][48][49][50][51] and 1 article analyzing pain in the first 2 hours of postsurgery. 52 Only 1 additional study from this second search was included in this systematic review ( Figure 1).…”

Stability and compatibility of admixtures containing bupivacaine hydrochloride and ketorolac tromethamine for parenteral use

“…1 A combination of local anaesthetic, bupivacaine hydrochloride (BH), and analgesic, ketorolac tromethamine (KT), is generally administered, as they offer efficient pain control with reduced opioid consumption. [2][3][4][5][6][7][8][9] They are administered either as separate injections 2 3 or in admixtures, [4][5][6][7][8][9][10][11][12] via various techniques such as wound infiltration, 4 11 irrigation solutions 6 7 or as a single injection at the wound site. 8 9 BH/KT admixtures are prepared either by direct mixing of their marketed parenteral products, 4 9 or via admixing in parenteral solutions at various concentrations and ratios such as 1.67 mg•mL −1 BH and 1 mg•mL −1 KT, 6 2.5 mg•mL −1 BH and 1 mg•mL −1 KT, 7 0.5 mg•mL −1 BH and 0.3 mg•mL −1 KT.…”