Ketorolac vs. tramadol for pain management after abdominal surgery in children

Abstract

Background Tramadol is a pure analgesic widely used for
postoperative treatment and well tolerated by children. Howevet;
it has only a 50% efficacy. Ketorolac, a nonô€™steroid anriô€™
inflammation drug (NSAID), is widely used in adults and has up
to 85% clinical efficacy. Data supporting the use of ketorolac in
children has been limited.
Objective To compare the clinical efficacies of intravenous
ketorolac and tramadol for moderateô€™toô€™severe pain management
after abdominal surgery in children.
Methods A doubleô€™blind controlled trial was conducted in Moh.
Hoesin Hospital, Palembang, from January to June 2012. Subjects
were postoperative children aged 1 ô€™ 7 years who met the inclusion
criteria. T hey were randomized into two groups who received
either intravenous ketorolac or tramadol. Subjects assessed
their pain level using the Face, Legs, Anns, Cry and Consolability
(FLACC) pain scale. T he FLACC scores ::::;3 were considered to
indicate clinical success of the intervention. Data were analyzed
by Tô€™test, Chiô€™square test, and Fischer's exact test.
Results Of the 60 subjects who underwent abdominal surgery with
general anesthesia, 31 (52%) were boys and 29 (48%) were girls.
Subjects' mean age and body weight were 3.7 (SD 1.82) years and
12.6 (SD 2.85) kg, respectively. Mean duration of surgery was 71.7
(SD 21.11) minutes and mean postô€™operative FLACC score was
6.6 (SD 0.5). Eight subjects dropped out of the study. Efficacies of
ketorolac and tramadol were not significantly different at 21/26 and
17/26, respectively (P=OJ5). In addition, there was no significant
difference in the number of patients experiencing a >3 FLACC
score decline between ketorolac and tramadol groups (P=0.61).
Conclusion T here is no significant difference in the efficacies
of intravenous ketorolac and tramadol for moderateô€™toô€™severe
pain management after abdominal surgery in children. [Paediatr
Indones.2014;54:118.21.].