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Ketorolac vs. Tramadol: Which is better for pain management in hernia surgery?

hernia mesh repair surgery hernia mesh repair surgery
hernia mesh repair surgery hernia mesh repair surgery

What's new?

Compared to intravenous Tramadol, intravenous Ketorolac exhibits better analgesic benefits and a safer side effect profile in open inguinal hernia mesh repair surgery.

In a study by Syed M Ahmed et al. intravenous Ketorolac outperformed intravenous Tramadol in analgesic efficacy and side effect profile in patients undergoing unilateral open inguinal hernia repair with mesh. This randomized controlled trial sought to compare the efficacy and safety of Ketorolac, a potent NSAID, to Tramadol for postoperative pain control. Overall, 60 patients were randomly allocated into 2 groups:

  • Ketorolac Group: Received Ketorolac injection postoperatively
  • Tramadol Group: Received Tramadol injection postoperatively

At 2, 6, 12, and 24 hours after surgery, an assessment of pain scores and vitals was done. Secondary outcomes encompassed time to ambulation, time to pass flatus, and time to resolve nausea.

Key findings:

  • Pain Management: Patients in the Ketorolac group experienced markedly lower pain scores when compared to the Tramadol group at all measured intervals, as shown in Figure 1:

  • Recovery Metrics:

(a) Nausea duration: Tramadol patients reported prolonged nausea.

(b) Bowel function: Faster return of bowel function was reported in the Ketorolac group, with a shorter time to pass flatus.

(c) Ambulation: Ketorolac patients were able to ambulate earlier than those in the tramadol group.

  • Vitals: No prominent differences were observed between the groups.

Ketorolac illustrated superior efficacy in pain management, enhanced recovery, and fewer side effects when compared to Tramadol in those undergoing hernia repair surgery. Hence, Ketorolac offers a safer, non-narcotic alternative to opioids like Tramadol for postoperative pain relief, addressing the global concern over opioid dependence. This study supports a shift toward NSAIDs like Ketorolac in postoperative care, particularly for common surgeries such as hernia repair.

Source:

Cureus

Article:

Comparing the Postoperative Analgesic Efficacy of Ketorolac and Tramadol After Open Inguinal Hernia Mesh Repair: A Randomized Controlled Trial

Authors:

Syed M Ahmed et al.

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