As per a recent study published in the May edition of Journal of Cardiothoracic Surgery, ketorolac offers the comparable efficacy to that of paracetamol in postoperative coronary artery bypass graft (CABG) pain relief.

As the management of pain following CABG surgery is quite challenging, this study by Fatemeh Javaherforooshzadeh and researchers intended to distinguish between the effects of ketorolac and paracetamol as effective analgesics after CABG in this randomized clinical trial study.

This study was performed in Ahvaz, Iran, from September 2018 till December 2019. Two consecutive groups of 60 patients undertaking elective on-pump coronary artery bypass graft surgery were considered. These patients were randomly given ketorolac 0.5 mg/kg and paracetamol 10 mg/kg after surgery for pain management. Visual analog pain scale (VAS) at the time point soon after extubation (baseline) and at 6, 12, 24 and 48 h and the total dose of morphine consumption was regarded as primary outcome. Hemodynamic variables, weaning time, chest tube derange, in-hospital mortality and myocardial infarction were regarded as secondary outcomes. SPSS version 22 was used to evaluate the data. The demographic data, VAS scores, vital signs, and side effects were compared using Mann-Whitney U-test. Friedman’s ANOVA and the Wilcoxon rank-sum test to test repeated measurements were tested within groups.

A significant decline in VAS scores were observed in both groups through the time period as compared with baseline scores. Paracetamol group portrayed slightly higher statistical VAS score at most time points, excluding for the time of 6 hours. At 24 and 48 hours, the VAS score in Paracetamol group was significantly higher as compared to Ketorolac group as shown in below:

No significant differences were observed considering the hemodynamic variables (like platelet count, bleeding time) between both groups.