This study was designed to test the effectiveness of combination of intranasal fentanyl and intravenous ketorolac in the prevention and the treatment of postoperative pain. Forty ASA I-IIpatients scheduled for upper abdominal surgery were randomized to two groups and one group received ketorolac 0.8 mg/kg intravenously (study group). All patients received general anesthesia consisting of thiopental, tracrium, isofluran and O-N2O. In the recovery room, all patients complaining from pain were treated with intra-nasally 8 sprays of fentanyl (0.025 pg). The dosage was repeated every 5 minutes until patients were satisfied. Before the beginning of opioid titration and 10, 20, 30, 40, 50, 60, 70, and 80 minutes thereafter, pain was evaluated with verbal pain score (on a 5 point scale). Combination of intranasal fentanyl and intravenous ketorolac resulted superior pain scores when compared to fentanyl alone. Patients who received intravenous ketorolac required significantly less intranasal spray than the control group. Ketorolac served as an effective postoperative "background" analgesic with supplemental intranasal fentanyl for breakthrough of pain. [Journal of Turgut Ozal Medical Center 1997;4(3):279-281]
Key Words: Intranasal fentanyl, ketorolac, postoperative analgesia
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