International Journal of Pharmaceutical and Phytopharmacological Research
ISSN (Print): 2250-1029
ISSN (Online): 2249-6084
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2020   Volume 10   Issue 5

A Comparison of the Efficacy of Dexamethasone and Ketorolac in Preventing Postoperative Pain and Side-effects in Gynecologic Laparoscopic Surgeries: A Double-blind Randomized Clinical Trial
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Zahra Asgari, Bahareh Meybodi, Masoumeh Nataj Majd, Reyhaneh Hosseini, Farahnaz Hajibeygi
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Abstract

Background: The impact of preoperative administration of dexamethasone and ketorolac on postoperative analgesia and side-effects of laparoscopic surgeries is acknowledged. However, the efficacy of dexamethasone versus ketorolac has not been compared in any earlier investigations, which was the main goal of this study.

Methods: In a randomized, double-blind placebo control study, 114 females who were elected for minor laparoscopic surgeries were randomly allocated into the three study groups: 30 mg preoperative intravenous ketorolac, 8 mg preoperative intravenous dexamethasone, and preoperative placebo (normal saline). Postoperative pain was evaluated at 1h, 6h, 12h, and 24h after the laparoscopy using the Visual Analog Scale (VAS) for pain. Postoperative opioid consumption and the occurrence of nausea and vomiting were also recorded. 

Results: Characteristic features of the study groups were similar. In comparison with the placebo group, postoperative pain over time and opioid consumption were significantly lower in the dexamethasone (p<0.001 and p=0.02, respectively) and ketorolac group (p<0.001 and p=0.002, respectively), while the occurrence of nausea and vomiting was significantly lower only in the dexamethasone group (p=0.03 for both). In comparison with the dexamethasone group, early postoperative pain was lower in the ketorolac group (p=0.01), while the incidence of postoperative nausea and vomiting was significantly smaller in the dexamethasone group (p=0.045 and p=0.03). The opioid usage was not significantly different between the dexamethasone and the ketorolac group (p=0.3).

Conclusion: In minor laparoscopic surgeries, preoperative ketorolac is more ‎efficacious for postoperative pain control, and dexamethasone can be used for patients in whom ‎postoperative control of nausea and vomiting is a priority.


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