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Effective postoperative pain mitigation is essential for patient satisfaction following minor hand surgeries, with multimodal analgesia playing a key role.
When used as an adjunct, Ketorolac (30 mg) injection provides better pain relief during finger motion within 6 hours after finger surgery than oral NSAIDs.
Effective postoperative pain mitigation is essential for patient satisfaction following minor hand surgeries, with multimodal analgesia playing a key role. This randomized controlled trial explored the potential benefits of local wound infiltration using Ketorolac as an adjunct in finger surgery. The goal was to compare pain levels and functional outcomes between local Ketorolac infiltration and oral non-steroidal anti-inflammatory drugs (NSAIDs).
This double-blind, parallel-design trial included 69 patients (aged between 18 and 75 years) who presented with Quinnell grade 2–4 single trigger digit and underwent open trigger finger release surgery. Volunteers were randomly allocated to:
(a) Ibuprofen alone group: Received 1 ml of normal saline solution injection prior to surgical wound closure and were given 400 mg of Ibuprofen (2 capsules) after surgery.
(b) Ketorolac alone group: Received 1 ml of Ketorolac (30 mg/ml) injection prior to surgical wound closure and were given a placebo (2 capsules) after surgery.
(c) Ketorolac + Ibuprofen group: Received 1 ml of Ketorolac (30 mg/ml) injection prior to surgical wound closure and were given 400 mg of Ibuprofen (2 capsules) after surgery.
In all the groups, the capsules were given 3 times/day for 5 days. Numeric Rating Scale (NRS) for pain, the Disabilities of the Arm, Shoulder, and Hand (DASH) score, complication rates, proximal interphalangeal joint mobility, and grip strength were evaluated after surgery.
At 6 hours post-surgery, the pain scores during finger movement were markedly lower in both the local Ketorolac alone group and the local Ketorolac + oral Ibuprofen group when compared to the oral Ibuprofen alone group. In terms of DASH scores, grip strength, proximal interphalangeal joint mobility, or complications, no pivotal differences were noted between the groups.
Local Ketorolac infiltration as part of multimodal analgesia provides better pain management during finger movement in the first 6 hours after trigger finger surgery and may serve as an alternative for patients with contraindications to systemic NSAIDs.
BMC Musculoskeletal Disorders
Local ketorolac infiltration for postoperative pain in open trigger finger surgery: a randomized controlled trial
Thanat Auwattanamongkol et al.
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