Reduced side effects and improved pain management by continuous ketorolac infusion with patient-controlled fentanyl injection compared with single fentanyl administration in pelviscopic gynecologic surgery: a randomized, double-blind, controlled study

Insun Park, Seukyoung Hong, Su Yeon Kim, Jung Won Hwang, Sang Hwan Do, Hyo Seok Na

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: A combination of opioids and adjunctive drugs can be used for intravenous patient-controlled analgesia (PCA) to minimize opioid-related side effects. We investigat-ed whether two different analgesics administered separately via a dual-chamber PCA have fewer side effects with adequate analgesia than a single fentanyl PCA in gynecologic pelvi-scopic surgery. Methods: This prospective, double-blind, randomized, and controlled study included 68 patients who underwent pelviscopic gynecological surgery. Patients were allocated to ei-ther the dual (ketorolac and fentanyl delivered by a dual-chamber PCA) or the single (fen-tanyl alone) group. Postoperative nausea and vomiting (PONV) and analgesic quality were compared between the two groups at 2, 6, 12, and 24 h postoperatively. Results: The dual group showed a significantly lower incidence of PONV during postoperative 2–6 h (P = 0.011) and 6–12 h (P = 0.009). Finally, only two patients (5.7%) in the dual group and 18 (54.5%) in the single group experienced PONV during the entire postoperative 24 h and could not maintain intravenous PCA (odds ratio: 0.056, 95% CI [0.007, 0.229], P < 0.001). Despite the administration of less fentanyl via intravenous PCA during the postoperative 24 h in the dual group than in the single group (66.0 ± 77.8 vs. 383.6 ± 70.1 μg, P < 0.001), postoperative pain had no significant intergroup difference. Conclusions: Two different analgesics, continuous ketorolac and intermittent fentanyl bo-lus, administered via dual-chamber intravenous PCA, showed fewer side effects with adequate analgesia than conventional intravenous fentanyl PCA in gynecologic patients undergoing pelviscopic surgery.

Original languageEnglish
Pages (from-to)77-84
Number of pages8
JournalKorean journal of anesthesiology
Volume77
Issue number1
DOIs
StatePublished - Feb 2024

Bibliographical note

Publisher Copyright:
© The Korean Society of Anesthesiologists, 2024.

Keywords

  • Analgesia
  • Fentanyl
  • Ketorolac
  • Patient-controlled analgesia
  • Postoperative nausea and vomiting
  • Postoperative pain

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