The addition of Ketorolac to the standard local anaesthesia regimen for patients undergoing multilevel posterior lumbar spinal fusion significantly reduces post-operative pain and decreases reliance on morphine, suggesting the outcomes of a randomized double-blind controlled trial posted in the ‘Spine’ journal.

Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), has shown potential in multimodal analgesia regimens for improving pain control and reducing opioid use.

This study by Nattharut Chaibhuddanugul and colleagues aimed to assess the efficacy of Ketorolac in managing pain and opioid consumption following spinal fusion surgery. The trial involved 47 patients (mean age of 60.9±6.9 years) who underwent multilevel lumbar decompression and posterolateral fusion. Patients were randomly assigned to receive either standard treatment with bupivacaine 0.5% alone (Group 1) or a combination of Ketorolac 30 mg and bupivacaine 0.5% (Group 12) injected directly into paraspinal muscles before wound closure. The numerical rating scale (NRS) was used to assess post-surgical back pain, leg pain, morphine usage, along with adverse events (complications).

Results from this trial demonstrated marked distinctions between the two groups. Patients who received Ketorolac reported lower levels of back pain at 6 hours’ post-surgery compared to those in the control group. Additionally, the patients in the Ketorolac group downed considerably less morphine in the first 24, 48, 72, and 96 hours after the spinal surgery compared to the other group. Neither of the two groups displayed any substantial disparities in post-surgical complications or adverse effects.