Comparing the efficacy of combining ketorolac and Paracetamol (Acetaminophen) with Paracetamol alone on postoperative pain after laminectomy. A double-blinded randomized clinical trial
Abstract
BACKGROUND: Postoperative pain management has driven a shift toward non-opioid analgesics. Combining Paracetamol (Acetaminophen) and Ketorolac, a multimodal analgesic approach shows potential. However, evidence on the synergistic effects of these combinations remains limited, particularly for laminectomy.
METHODS: This randomized, double-blinded controlled trial was conducted between March 2023 and December 2024. Eligible patients were adults undergoing laminectomy who met the inclusion and exclusion criteria. Participants were randomized to receive either conventional Paracetamol (1000 mg) with or without Ketorolac (30 mg) every 6 h for 24 h. Primary outcomes included postoperative morphine consumption and pain intensity measured by the Visual Analogue Scale (VAS). Secondary outcomes included hemodynamic changes and the incidence of postoperative nausea and vomiting (PONV).
RESULTS: A total of 90 patients completed the study, with comparable baseline demographics between groups. The intervention group required significantly less morphine (0.35 ± 0.95 mg) compared to the control group (1.33 ± 3.03 mg) in the first 24 h post-surgery (p = 0.02). Pain intensity decreased over time in both groups, with no significant differences observed in VAS scores. Hemodynamic parameters were more stable in the intervention group, with lower systolic and diastolic blood pressures over time; however, some results were not statistically significant. The incidence of PONV was similar between…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 90 participants or records.
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.