Comparison of ketorolac with morphine for Intra-operative analgesia in patients undergoing total abdominal hysterectomy

ABSTRACT

To compare ketorolac 0.35 mg.kg-1 with morphine 0.1 mg.kg-1 for hemodynamic stability, efficacy of analgesia and incidence of side effects in patients undergoing elective total abdominal hysterectomy. Fifty ASA I and II patients, were enrolled in a prospective, randomized and double blind study. They were divided in two equal groups. Group K received Inj. Ketorolac 0.35 mg.kg-1 while group M received Inj. Morphine 0.1 mg.kg-1 5 minutes before induction of anaesthesia. Hemodynamic responses to laryngoscopy, endotracheal intubation, and surgical incision were noted. Data was entered and analysis was done using SPSS version 10.0. Student-t test and comparison of proportions were done where required. ANOVA was done and a p - value of <0.05 was considered statistically significant. There was a significant rise in heart rate, systolic, diastolic and mean arterial pressure in ketorolac group [K] as compared to baseline values at points of endotracheal intubation and surgical incision. Patients in Morphine group [M] showed a significant increase in heart rate only. There was no statistically significant difference between the two groups for supplemental analgesia requirement Intraoperatively and postoperatively. Complications seen with group K were increased surgical wound bleeding in 2 patients [8%], nausea and vomiting in 4 patients [16%] while in group M there was nausea and vomiting in 5 patients [20%], and respiratory depression in 1 patient [4%]. Although hemodynamic stability at points of painful stimulation was lower in patients given ketorolac as compared to morphine, Ketorolac has a place in the intraoperative pain relief in Pakistan and other developing countries where availability of powerful narcotics is erratic