As senior author Dr. Hae Keum Kil told Reuters Health by email, co-administration of 1 mg/kg ketorolac and 20 mg/kg acetaminophen “provides efficient analgesia and fentanyl-sparing effect postoperatively in children undergoing ambulatory inguinal hernioplasty.”
Dr. Kil and colleagues at Yonsei University College of Medicine, Seoul, randomized 55 children, ages 1 to 5, to receive either ketorolac and acetaminophen intravenously, or placebo, after induction of anesthesia. All received 1 mcg/kg of fentanyl before incision.
Eight children (28.6%) in the treated group and 22 (81.5%) in the control group required more than one dose of fentanyl in the recovery ward. Two treated children and 11 controls required more than two doses (7.1% vs 40.7%).
The control group received a larger total dose of fentanyl and had higher rates of sedation (55.6% vs 25.0%) and vomiting (33.3% vs 10.7%) than the combination group.
“A single preoperative intravenous administration of ketorolac and acetaminophen is a simple, safe and effective method for relieving pediatric postoperative pain, and demonstrates highly significant fentanyl-sparing effects,” the investigators conclude.
J Urol 2010;183:1551-1555.