Comparison of Ketorolac and Morphine for Postoperative Pain Control after Cesarean Section under General Anesthesia
Keywords:
Ketorolac, Morphine, General Anesthesia, Cesarean Section, PainAbstract
Objectives: To compare the clinical efficacy of ketorolac and morphine for post cesarean section under general anesthesia. To determine the efficacy of postoperative pain control within 24 hours, side effects and times to request.
Materials and Methods: This was a randomized controlled trial comparing the effectiveness of ketorolac and morphine in the pregnant women who underwent cesarean section under general anesthesia. The subjects were randomly divided in to ketorolac and morphine group. Ketorolac group received 30 mg of ketorolac and morphine group received 10 mg of morphine intramuscular when visual analog scores (VAS) of pain over ≥6 every 6 hours after the surgery. VAS was recorded at 3, 6, 12 and 24 hours postoperative. Demographic data of patients, side effects and times to request were recorded. Statistical analysis use t-test and exact probability test with significant level at p<0.05.
Results: There were 66 and 66 cases in ketorolac and morphine group. Both groups showed no statistical difference in weight, height, mean age, gestational age, blood loss, parity and underlying disease but difference significantly in occupations, indication of cesarean section, fetal weight and operative time. Either ketorolac or morphine group showed no significant postoperative pain relief at 3, 6, 12 and 24 hours (MD = -0.21, 0.15, 0.33, 0.02, 95%CI = -0.91-0.48, -0.49-0.80, -0.31-0.97, -0.34-0.37). Ketorolac group had less nausea, vomiting and dizziness (p <0.001) than morphine group.
Conclusion: Ketorolachad equal efficacy to morphine but less nausea, vomiting and dizziness than morphine. It could be an alternative medication for pain control in post cesarean delivery.
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