The effect of ketorolac and propacetamol on pain control after tonsillectomy in pediatric patients

Abstract

Background: Both ketorolac and propacetamol have been used to control mild to moderate pain after operation. Ketorolac is a non-steroid anti-inflammatory drug (NSAID) with strong analgesic activity, but should be avoided in patients with renal dysfunction or bleeding complications. Propacetamol is a prodrug of paracetamol and can be delivered intravenously. Importantly, it has fewer side effects and therefore generally considered safe. The purpose of this study is to compare the analgesic efficacy of ketorolac and propacetamol for pain control after tonsillectomy in pediatric patients. Methods: The pediatric patients were randomly divided into three groups. All patients were given propofol and fentanyl for induction. During induction, one group received ketorolac 1 mg/kg (group K), another group received propacetamol 30 mg/kg (group P), and the other group received saline (group C). Postoperative pain was assessed by Visual Analogue Scale (VAS) and Faces Pain Scale (FPS) at 15, 30 and 60 min after arrival at the recovery room. Results: VAS and FPS at 30 and 60 min after arrival were significantly lower in group K and P than in group C (P ＜ 0.05). No adverse side effect was observed in all groups after tonsillectomy. Conclusions: Propacetamol can be used as a safe alternative to ketorolac for pain control after tonsillectomy in pediatric patients. (Korean J Anesthesiol 2008; 55: 704~8)