This case report describes a
general anesthetic where
ketorolac tromethamine was used instead of a
narcotic. The patient was a 37-year-old male, ASA II category, who underwent
general anesthesia for a
cholecystectomy. The
drug is discussed in terms of preoperative, intraoperative, and immediate postoperative effects. During the preoperative phase, no effect was demonstrated. Intraoperatively, the
drug performed poorly to attenuate responses to intense stimulation as noted by an increase in pulse and blood pressure of greater than 20% during intubation, incision, and abdominal wall retraction. During the immediate postoperative phase, the
drug performed well to provide
analgesia related to incisional
pain.
Ketorolac has not been previously discussed in terms of intraoperative uses. The mechanism of action by which it provides
analgesia is through the inhibition of
prostaglandin synthesis. It is similar in structure to the other nonsteroidal anti-inflammatory drugs and may offer certain advantages over traditional agents used to provide
analgesia, including the absence of
respiratory depression, addictive potential, euphoria, a decrease in gastric motility, and cardiovascular effects. These properties may help in the management of certain types of patients who are at risk for
respiratory depression or in those who have a
contraindication to
narcotics.