Dwayne Accardo, DNP, CRNA, APRN
Investigative Techniques | Medicine and Health Sciences | Nursing
The purpose of this project will compare the effectiveness of ketorolac over opioids alone for pain management of patients 72 hours postoperatively.
In recent years, there has been overwhelming evidence of opioid abuse and its adverse effects on patients’ lives. To combat this, significant attention has been paid to multimodal analgesia throughout the perioperative period to decrease patients’ exposure to opioids. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ketorolac, are being administered intraoperatively to reduce the need for opioids in patients' post-surgical procedures.
A literature review was done on articles that evaluated perioperative adult human patients undergoing elective general anesthesia procedures in which the use of intraoperative NSAIDs, without narcotics, is justified. Eligibility criteria includes full-text, peer-reviewed, English articles within the last ten years that includes international studies. Search databases include a Boolean search of CINAHL, PubMed, Cochrane Library, and Google Scholar. Data abstracted are pain adjuncts, hemodynamic variables, pain scales, and patient satisfaction. Boolean operators used: “ketorolac” OR "toradol" AND “multimodal” AND “opioid” OR “narcotic” AND “intraoperative” OR “perioperative.”
Conclusions were drawn from eight research articles which were appraised for the scoping review. The review suggests that ketorolac is as effective or superior to opioid medication for perioperative pain relief. The results also suggest that ketorolac decreases perioperative opioid consumption. Finally, ketorolac is no better or worse than opioids when judged on clinical healing time, side effects, and duration of analgesia.
Implications for Nursing Practice
This scoping review provides insight for the utilization of non-opioid analgesia for control of pain management postoperatively for surgical patients. With opioids being highly abused and having unwanted side effects, our review highlights evidence of reducing the use of opioids along with reducing postoperative pain and undesired side effects. Anesthesia providers should enhance their education on the benefits of using ketorolac intraoperatively versus the administration of opioids in the operating room.
Smith, Jamie BSN, SRNA; Warner, Ashley BSN, SRNA; Tubre, Oran BSN, SRNA; Stauffer, Sherman BSN, SRNA; and Accardo, Dwayne DNP, CRNA , "Effectiveness of Perioperative Ketorolac versus Opioids: A Scoping Review" (2023). Doctor of Nursing Practice Projects. Paper 59. http://dx.doi.org/10.21007/con.dnp.2023.0059.