Purpose: 

Intravenous ketorolac (IVK) is an effective and safe medication to reduce postoperative pain in the setting of oculofacial surgery. This study was undertaken to determine the impact of timing of IVK administration in orbital surgery on the reduction of postoperative pain score and opioid requirement.

Methods: 

Patients either received IVK immediately before (n = 50), during (n = 50) or after (n = 50) orbital surgery or acted as controls (n = 50). Pain scores were assessed via an analog scale immediately after surgery and on the first postoperative day. The requirements for opioid analgesics were recorded. Statistical analyses were performed via a dedicated computerized software package.

Results: 

One hundred fifty patients received IVK; 50 before incision (28 males, 22 females, mean age 52.2), 50 intraoperatively (20 males, 30 females, mean age 49.8) and 50 in the immediate postoperative period (26 males, 24 females, mean age = 55.3). Additionally, 50 patients acted as controls (26 males, 24 females, mean age 54). Immediately after surgery, administration of IVK resulted in statistically significant reduction in pain score regardless of the timing of dosing as compared with control patients (prior = 2.36, intraoperative = 2.34, postoperative = 2.46 vs. control 5.44, p < 0.0001). Eleven patients (22%) in the control group required opioids, whereas, in the IVK cohorts, only 2 (4%—preoperative), 1 (2%—intraoperative), and 1 (2%—postoperative) patients needed these medications (p = 0.0039).

Conclusions: 

In the setting of orbital surgery, IVK reduced pain scores and opioid requirement, regardless of the timing of administration, as compared with patients that did not receive the medication.

中文翻译：

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静脉注射酮咯酸时机对眼眶切开术中疼痛的影响

目的： 

静脉注射酮咯酸（IVK）是一种有效且安全的药物，可减轻眼面手术的术后疼痛。本研究旨在确定眼眶手术中 IVK 给药时机对减少术后疼痛评分和阿片类药物需求的影响。

方法： 

患者在眼眶手术前 (n = 50)、手术期间 (n = 50) 或手术后 (n = 50) 立即接受 IVK，或作为对照 (n = 50)。手术后立即和术后第一天通过模拟量表评估疼痛评分。记录阿片类镇痛药的需求。通过专用的计算机化软件包进行统计分析。

结果： 

一百五十名患者接受了 IVK；切口前 50 例（男性 28 例，女性 22 例，平均年龄 52.2 岁），术中 50 例（男性 20 例，女性 30 例，平均年龄 49.8 岁），术后即刻 50 例（男性 26 例，女性 24 例，平均年龄 = 55.3 岁）。此外，50 名患者作为对照（26 名男性，24 名女性，平均年龄 54 岁）。与对照患者相比，手术后立即施用 IVK 导致疼痛评分显着降低，无论给药时间如何（术前 = 2.36，术中 = 2.34，术后 = 2.46 对比对照 5.44，p < 0.0001 ）  。对照组中有 11 名患者 (22%) 需要阿片类药物，而在 IVK 队列中，只有 2 名（4%——术前）、1 名（2%——术中）和 1 名（2%——术后）患者需要这些药物。p  = 0.0039）。

结论： 

在眼眶手术中，与未接受药物治疗的患者相比，无论给药时间如何，IVK 都能降低疼痛评分和阿片类药物需求。