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 RESEARCH PAPER
Year : 1996  |  Volume : 28  |  Issue : 4  |  Page : 240-243

Ketorolac vs nefopam: Comparison of single intravenous dose in relieving post-operative pain following laparotomy


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Kumar Sunil


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Ketorolac and nefopam are two newly introduced non-steroidal non-narcotic analgesics. Their comparative analgesic efficacy is not known. Therefore this prospective double blind randomized clinical trial was conducted in 161 patients after single intravenous (I.V.) bolus dose of these two drugs for relieving acute post-operative pain following upper abdominal surgery. 100 patients received 30 mg ketorolac (group A) while 61 patients received 20 mg nefopam (group B). Both the groups were comparable in terms of age and sex. Pain assessment was done at frequent intervals upto 6 hrs using a 10 point visual analogue scale VAS). Simultaneously pulse and blood pressure were recorded. Pain intensity difference (PID) and total pain relief (TOTPAR) were calculated using standard formulae. PID curves suggested that group B patients had better analgesia for first 4 hrs but it worsened in the last 4 hrs. On the other hand, group A patients had progressive analgesia till 7 h which slightly decreased during last hour of the study. TOTPAR for the entire study period was significantly (p=0.002) greater in group B than group A. TOTPAR during first 4 hrs of study was also significantly (p=0.0001) greater in group B than group A. However, TOTPAR during last 4 hrs of study was significantly (p=0.001) greater in group A as compared to group B. Further, significantly (p=0.006) lesser number of patients in group A demanded second dose of analgesia at night as compared to group B. No drug related complications were seen, and pulse rate and mean arterial pressure remained within the normal limits in both groups. To conclude, 30 mg ketorolac provides progressively increasing and lasting pain relief compared to 20 mg nefopam when used as single I.V. bolus dose in immediate post-operative period following upper abdominal surgery. However, the reported side effects of ketorolac need caution during multi-dose therapy which itself may reveal a different picture of the analgesia achieved.






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