Analgesic effect of ketorolac added to lidocaine in surgery of traumatic arm injuries: A double-blind, randomized clinical trial

This randomized and double-blind clinical trial aimed to compare the analgesic effect of intravenous injection of ketorolac when lidocaine is added to Bier's block in surgery of traumatic upper limb injuries. The selected patients were randomly assigned to three study groups. The intensity of pain, the amount of morphine consumed through an intravenous patient controlled analgesia (PCA) pump, the incidence of morphine and ketorolac side effects and the patient's overall satisfaction were compared between groups. The three groups studied were similar and did not statistically differed in terms of quantitative and qualitative demographic variables. The median tourniquet closing time was different between the control group and the intravenous ketorolac and topical ketorolac groups with p=0.002 and p=0.001, respectively. There was no significant difference between the three groups in terms of time of the first request to receive painkillers after deflating the tourniquet, but the amount of morphine received between the groups was significantly different (p=0.02). Comparison of pain intensity based on numerical rating scale (NRS), considering the repetition times of the measurement, showed a significant difference in pain intensity between groups (p = 0.001) Overall satisfaction with the quality of analgesia and method of anesthesia did not differ significantly between the three study groups.. The groups receiving ketorolac did not presented of drug-related complications. In summary, ketorolac reduces the intensity of postoperative pain both during the time spent in the recovery room and during the transfer to the hospital ward, thus reducing the overall amount of morphine received by patients.