WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Tabish Hussain*, Asifa Anwar Mir, Jawad Zahir, Pervaiz Minhas and Mubashar Iqbal

ABSTRACT

Introduction: Analgesia in the form of pharmacological and non-pharmacological intervention is mandatory to manage pain, so as to limit the neuro-endocrine response to surgery and pain. Inappropriate postoperative pain control has been associated with a number of complications. The sequel of peripheral and central modulation in nociception has given the concept of preemptive analgesia in patients undergoing various kinds of surgeries. NSAIDs like Ketorolac inhibit the (COX) cyclo-oxygenase enzymes, and decrease peripheral central prostaglandin production thus reducing pain. The objective of our study was to understand the efficacy of pre-emptive Ketorolac for post operative pain among patients undergoing operative laparoscopic cholecystectomy. Methods: The study was conducted at Cantonment General Hospital, Rawalpindi from Jan 2020 to Dec 2020 over a period of 1 year. A total of 50 patients undergoing laparoscopic Cholecystectomies were enrolled in the study. Patients were randomly divided in group A (n=25) and B (n=25) by consecutive non probability lottery method. SPSS version 17.0 was used to analyze the data. The post-operative pain was assessed by using Visual Analog scale (VAS) graded no pain (0 score) to worst unbearable pain (10 score). Patients complaining moderate to severe pain (pain score 5 or above) in either group at 4 hours or even before postoperatively were given rescue analgesic. Results: There were 25 patients in each group. The baseline parameters of all study participants were comparable with no significant differences. Mean age of study patients was 40.6 ± 6.3 years. The mean weight (kg), height (m) and BMI (kg/m2) of all study patients were 66.4 ± 10.5, 1.57 ± 0.11 and 27.8 ± 3.4 respectively. The mean duration of surgery was 45.7 ± 5.5 min. Overall 48 (96%) patients had either no pain (0 score) or complained of mild pain (1-4 Score) at 4hrs post operatively whereas only 2 (4%) patients had moderate pain. There were no patients with severe post operative pain at 4hrs. Conclusion: Pre-emptive use of Ketorolac for the management of post-operative pain especially among patients undergoing laparoscopic cholecystectomy is highly significant. It definitely reduces the pain intensity as well as the duration, thus provides an enhanced recovery after surgery (ERAS).

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