Key result
Ketorolac significantly reduced visual analog pain scale scores at 24 and 48 hours compared to paracetamol after coronary artery bypass graft surgery (p<0.05).
Why the study?
Pain management after coronary artery bypass graft surgery remains challenging.
Does ketorolac improve postoperative pain relief compared to paracetamol in patients undergoing elective on-pump CABG surgery?
RCT (n=60)
Double-blind
Computer-generated random digits with 1:1 allocation using random block sizes of 2
No
Does ketorolac improve postoperative pain relief compared to paracetamol in patients undergoing elective on-pump CABG surgery?
Absolute Event Rate: 2.18% vs 0.22%
p-value: p=0.007
Intravenous ketorolac provides comparable or slightly superior postoperative pain relief (lower VAS scores at 24 and 48 hours) compared to paracetamol after on-pump CABG surgery, without increasing bleeding or renal complications.
Supports ketorolac preference in post-CABG analgesia; extends RCT evidence versus paracetamol in cardiac surgery.
Introduction : Pain management after coronary artery bypass graft (CABG) surgery remains challenging. Objective This study aimed to compare the effects of Ketorolac and Paracetamol on postoperative CABG pain relief. Method: This double-blind randomized clinical trial study was conducted in Ahvaz, Iran, from September 2018- December 2019. Two consecutive groups of 60 patients undergoing elective on-pump coronary artery bypass graft surgery. Intervention The patients were divided into 0.5 mg/kg of ketorolac mg/dl and 10 mg/kg of Paracetamol after surgery for pain management . Primary outcomes were: visual analog pain scale (VAS) at the time point immediately after extubation (baseline) and at 6, 12, 24 and 48 hours and the total dose of morphine consumption. Secondary outcomes included the hemodynamic variables, weaning time, chest tube derange, in-hospital mortality and myocardial infarction. Statistical analysis: The data were analyzed using SPSS version 22(SPSS, Chicago, IL). The Mann-Whitney U-test was used to compare demographic data, VAS scores, vital signs, and side effects. Repeated measurements were tested within groups using Friedman's ANOVA and the Wilcoxon rank-sum test. Values were expressed as means ± standard deviations. Statistical significance was defined as a p-value < 0.05. Results : Compared with baseline scores, there were significant declines in VAS scores in both groups throughout the time sequence (P＜ 0.05). The statistical VAS score was slightly higher in the Paracetamol group at most time points, except for the time of 6 h. However, at 24 and 48 hours, the VAS score in group Paracetamol was significantly higher than in group Ketorolac. There were no significant differences between groups about hemodynamic variables. Conclusion: The efficacy of ketorolac is comparable to that of Paracetamol in postoperative CABG pain relief. Trial registry: IRCT20150216021098N5. Registered at 2019-09-12
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Javaherforooshzadeh et al. (2020) conducted an RCT in Postoperative pain after coronary artery bypass graft (CABG) surgery (n=60). Ketorolac vs. Paracetamol 10 mg/kg IV each 6 hours was evaluated on Morphine consumption at 48 hours (mg) (p=0.007). Ketorolac significantly reduced visual analog pain scale scores at 24 and 48 hours compared to paracetamol after coronary artery bypass graft surgery (p<0.05).
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