comparison of analgesic efficacy of ketorolac and piroxicam for postoperative pain relief after cholecystectomy

ABSTRACT

A Randomized Control Trials [RCT] single blinded study was designed to evaluate the analgesic efficacy of ketorolac and compare its effectiveness with the analgesic efficacy of piroxicam for postoperative pain management after cholecystectomy at Department of Anaesthesiology and intensive care, PNS Shifa Hospital, Karachi. In this study, fifty patients who had to undergo cholecystectomy were randomized in two groups. The patients were followed for 72 hours post operatively. All the patients were operated through a standard subcostal incision [3 to 4 inches in length]. The patients were American Society of Anaesthesiology status [ASA] of I, II, of both the sexes, aged between 30 to 60 years. A balanced anaesthetic technique was used for all the patients during the conduct of procedure. First dose of both the drugs was given immediately after induction [30 mg Ketorolac I/V and 20 mg Piroxicam I/M]. Postoperatively, group I patients received injection Ketorolac 30mg I/V 8 hourly, group II patients were given injection Piroxicam 20 mg I/M once daily. If pain persistently remained above 5 on visual analogue scale [VAS], injection Pethidine 50 mg I/V p.r.n. was used as rescue analgesia for both the groups.. In group I [ketorolac group] only 5 patients [20%] required rescue analgesia whereas in group II eight patients [32%] required it. The effect of both the drugs on pulse rate, blood pressure, respiratory rate and oxygen saturation were monitored and recorded. The frequency of postoperative complication was recorded. Relevant laboratory data [bleeding time, platelets count, serum urea and electrolytes and liver function tests] was monitored. Both the drugs were found effective in controlling postoperative pain. Both drugs Ketorolac and Piroxicam provided adequate pain relief