Intravenous ketorolac during DCR
Reviewed by Hetvi Bhatt

This study compares pain scores postoperatively between patients that received intravenous ketorolac (IVK) pre, intra or immediately postoperatively and a control group that did not receive it. The authors state that the patients were randomised, however it is not described how, and in the methods they mention that this depended on “anaesthesia providers’ practice patterns”. Randomisation aside, the article nicely demonstrates that irrespective of the timing of administration of IVK, those that received it had statistically significantly reduced pain scores following dacrocystorhinostomy (DCR) surgery compared to those that did not. On the same day, postoperatively, the mean pain score was 5.26 for control patients and 2.30, 2.44 and 2.36 for IVK given pre-, intra- and postoperatively (p<0.001 for each when compared to control). On postoperative day one, the mean pain score was 3.52 for controls and 1.38, 1.32 and 1.28 for IVK given pre-, intra- and postoperatively (p<0.001 for each when compared to control). The administration also resulted in a statistically significant reduction in the need for postoperative opioid analgesia and there were no haemorrhagic complications.

Does time of administration of intravenous ketorolac impact pain-related outcomes in dacryocystorhinostomy?
Waldis EJ, Shah V, De A.
ORBIT
2023;42(2):161-5.