A comparison between ketorolac and diclofenac in laparoscopic sterilization.

ABSTRACT

PIP: A comparison of two non-steroidal anti-inflammatory drugs (NSAIDs), ketorolac and diclofenac, indicates both were relatively ineffective for treating pain after laparoscopic sterilization. NSAIDs produce analgesia by inhibiting the synthesis of prostaglandins. Patients were randomly assigned to receive intramuscular injections of either 75 mg of diclofenac (n = 25) or 30 mg of ketorolac (n = 25) 30-90 minutes before surgery. There were no major anesthesia or surgical complications. The median duration of surgery, time from initial dose of NSAID to arrival in the recovery room, and length of stay in the recovery room were 20, 75, and 60 minutes, respectively, in both groups. Only 4 women in the diclofenac group and 5 in the ketorolac group did not require further analgesia after surgery, but 60% had adequate analgesia after a second NSAID dose. Pain scores, postoperative nausea and vomiting, and the requirement for anti-emetics did not differ between groups. Injection site pain lasted 15-30 minutes after ketorolac compared with 8-12 hours after diclofenac. While the analgesic potency of ketorolac is about 5 times that of diclofenac, the anti-inflammatory potency of ketorolac is only twice that of diclofenac.