Comparison of Analgesic Effects of Ketorolac Plus Apotel to Meperidine in Patients Undergoing Right Thoracotomy: A Double-Blind Randomized Clinical Trial.

Background: Postoperative pain management using nonsteroidal anti-inflammatory drugs with no narcotic-attributed adverse effects, such as respiratory depression, nausea, and vomiting, is still the subject of extensive research. However, concerns about bleeding and nephrotoxicity have limited routine use.

Objectives: The present trial aimed to compare the effects of ketorolac/apotel and meperidine on postoperative pain relief in patients undergoing thoracotomy.

Methods: This randomized controlled trial enrolled 122 patients who were candidates for right thoracotomy. The patients were randomly divided into two groups that received ketorolac (30 mg)/apotel (1 g) or meperidine (0.5 - 1 mg/kg) at the beginning of recovery, respectively. This study assessed the Numeric Rating Scale pain score immediately and 30 and 60 minutes after the surgery in the recovery room, blood pressure, oxygen saturation (SpO₂), sweating, and pulse rate.

Results: The average pain score at recovery time was significantly lower in the ketorolac/apotel group (2.06 ± 1.40) than in the meperidine group (2.76 ± 1.61) (P = 0.011). In contrast to the ketorolac/apotel group, an increasing trend was observed in pain scores in the meperidine group throughout the time sequence (P < 0.05). However, a slight non-significant increase was also observed in the ketorolac/apotel group. No statistical differences were observed in blood pressure (P = 0.826), SpO₂ (P = 0.826), and pulse rate (P = 0.811) between the two study groups.

Conclusions: This study provides support that the combination of ketorolac/apotel offers a slightly superior analgesic effect for patients undergoing thoracotomy, compared to meperidine. Pain management is crucial during recovery, and the current study's findings suggest that administering ketorolac/apotel provides effective analgesia during recovery after thoracic surgery.