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Adjunctive ketorolac significantly decreases narcotic utilization following arthroscopic rotator cuff repair.
A prospective, randomized controlled study depicted that using a combination of intravenous and oral ketorolac regimen as an adjunctive agent is beneficial to minimize narcotic utilization in adult patients undergoing primary arthroscopic rotator cuff repair. Researchers undertook this study to determine ketorolac's effectiveness as an adjunctive agent for postsurgery pain management following shoulder surgery.
Participants scheduled to undergo arthroscopic rotator cuff repair were segregated into 2 groups: (i) Ketorolac group: Given standard-of-care protocol, intravenous ketorolac after the procedure, and oral ketorolac after being discharged from the hospital, and (ii) Control group: Given standard-of-care protocol, including oxycodone-acetaminophen (5 to 325 mg) after being discharged from the hospital.
Recording of pain, functional outcome scores, and narcotic utilization was done three times per day for the initial five days post-surgery. At least six months post-surgery, repeat magnetic resonance imaging (MRI) was conducted. In this study, 39 people (mean age 55.7 ± 10.6 years, 66.7% males) were incorporated for the final assessment. In terms of preoperative demographics, functional scores, comorbidities, and cuff tear morphology, no differences were noted between the study groups.
In the initial five days after surgery, ketorolac-treated people consumed a mean of 10.6 fewer narcotic pills, an intake decrease of 54.6% (19.42 versus 8.82). Regarding functional outcome scores up to six weeks after surgery and adverse events, no inter-group difference was noted. No cases of gastrointestinal bleeding or gastritis were noted.
Notably, 22/39 people underwent repeat MRI at a mean of 7.9 months after surgery. Out of 22 people, 5 people (22%) showed a retear of their rotator cuff. Regarding the rate of retear, no profound difference was noted between the study groups.
Journal of the American Academy of Orthopaedic Surgeons
Oral Ketorolac as an Adjuvant Agent for Postoperative Pain Control After Arthroscopic Rotator Cuff Repair: A Prospective, Randomized, Controlled Study
Lakshmanan Sivasundaram et al.
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