Efficacy and Safety of Intravenous Ketorolac versus Nalbuphine in Relieving Postoperative Pain after Tonsillectomy in Children

Islam Adel Eladl; Karim Hussein Mourad; Ahmed Nabih Youssef; Abdelrazek Ahmed Abdelrazek; Mohamed Ahmed Ramadan

doi:10.3889/oamjms.2019.243

Authors

Islam Adel Eladl Department of Anesthesia, Surgical Intensive Care Unit and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt
Karim Hussein Mourad Department of Anesthesia, Surgical Intensive Care Unit and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt
Ahmed Nabih Youssef Department of Anesthesia, Surgical Intensive Care Unit and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt
Abdelrazek Ahmed Abdelrazek Department of Anesthesia, Surgical Intensive Care Unit and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt
Mohamed Ahmed Ramadan Department of Anesthesia, Surgical Intensive Care Unit and Pain Management, Faculty of Medicine, Cairo University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2019.243

Keywords:

ketorolac, analgesia, nalbuphine, postoperative pain, Adenotonsillectomy

Abstract

BACKGROUND: Pain is a major postoperative complication worldwide, which in turn impairs normal body performance and increases postoperative morbidity, hospitalisation, and the susceptibility to infections which also lead to chronic pain development.

AIM: The purpose of this study was to evaluate the efficacy of intravenous ketorolac versus nalbuphine as analgesia after adenotonsillectomy surgery to determine the optimal procedure for pain control and postoperative reduction of analgesic use.

METHODS: A group of 100 pediatric patients undergoing tonsillectomy or adenotonsillectomy were assigned as follows to two equal groups: Group A: 50 patients received intravenous ketorolac 0.9 mg/Kg. Group B: 50 patients received intravenous nalbuphine 0.25 mg/Kg.

RESULTS: FLACC (Face, Legs, Activity, Cry, Consolability) pain score was measured after recovery from anaesthesia (postoperative). There was a statistically significant difference concerning pain score between group â€˜Aâ€™ and group â€˜Bâ€™ as pain score in 'A' (ranging from 3.18 Â± 0.87 to 4.68 Â± 0.74) is lower compared to 'B' (ranging from 3.90 Â± 0.76 to 5.54 Â± 0.73) and probability value < 0.05 except at 90 & 120 min which was observed statistically insignificant. There was no serious postoperative complication detected in either group.

CONCLUSION: It is concluded that intravenous ketorolac is more effective than intravenous nalbuphine in reducing pain intensity and postoperative analgesic requirements after adenotonsillectomy in children.

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