EVALUATION OF ADDING KETOROLAC ON FENTANYL IN PATIENT-CONTROLLED INTRAVENOUS ANALGESIA (PCIA) AFTER ORTHOPEDIC SURGERY

Background and aims: Pain control techniques have a main role in the poetoperative period. Systemic opioids have been administered as a gold standard for reducing the severe pain after surgery but side effects such as nausea and vomiting, itching, urinary retention, respiratory depression, and so on, may be inhibit the use of adequate doses of opioids. For these reasons drug combination may be useful for reducing the amount of opioid. Ketorolc is the first intravenous NSAIDs approved and may be used for postoperative pain control. The main goal of this study was comparison of adding ketorolac to fentanyl for postoperative pain relief. Methods: In this study, sixty patients, 18-65 years, ASA I - II were candidated for posteoperative pain relief by patient-controlled iv analgesia (PCIA) after orhtopedic surgery. PCIA pumps were adjusted to 5ml/h. Patients divided in to F (fentanyl) and FK (fentanyl and ketorolac) groups. Each ml of analgesic solution in F group contained 10 mcg fentanyl, and in group FK contained 5 mcg fentanyl and 300 mcg ketorolac. Pain score (VAS and VRS), sedation score (Ramsy scale), nausea and vomiting. The amount of analgesic consumption during 6, 12, 24, 36 and 48h after operation were recorded. Results: Demographic findings in both groups was similar. Pain score (VRS and VAS) at all times in the group FK was less than group F. Complications in group FK were lower than group F, but patient satisfaction in group FK was higher than in group F. Conclusion: Findings of this study suggests that adding of ketorolac to fentanyl regiment in post operative pain control, not only decreases fentanyl consumption and its side effects, but also increases patient satisfaction. Keywords: Ketorolac, fentanyl, orthopedic surger