Does ketorolac produce preemptive analgesic effects in laparoscopic ambulatory surgery patients?

The purpose of this study was to determine whether intravenous ketorolac tromethamine could produce preemptive analgesia in patients undergoing laparoscopic gynecologic surgical procedures. Each patient's response to pain was measured by the mechanical visual analogue scale (M-VAS) and total analgesic use. By using a double-blind design, 49 patients were randomized into the preemptive group (n = 25), which received ketorolac preoperatively, or the control group (n = 24), which received ketorolac at the conclusion of surgery. Comparisons in pain scores using the M-VAS were made at 6 intervals in the postanesthesia care unit and 24 hours after the procedure. Further comparisons of the total fentanyl use and total postoperative oral analgesic requirements were analyzed. The preemptive group experienced higher pain scores and postoperative fentanyl use. Only the pain change from baseline between the 2 groups was statistically significant. Total fentanyl use and postoperative oral analgesic use was not statistically significant. Clinically, the preemptive administration of ketorolac to patients undergoing laparoscopic gynecologic surgery did not demonstrate preemptive analgesic effects.