Intravenous acetaminophen vs. ketorolac for postoperative analgesia after ambulatory parathyroidectomy

Background and methods: Minimally invasive parathyroidectomy requires limited analgesia and short recovery times. The preferred post-operative analgesic regimen for this patient population has not been established but non-narcotic components would be quite appropriate. The aim of the study was to determine whether intravenous (IV) acetaminophen (1 g) or ketorolac (30 mg) provide better pain control after parathyroidectomy. A parallel, randomized, double blind, comparative study was completed on 180 patients scheduled for outpatient parathyroidectomy utilizing general anesthesia. Patients were randomized to a blinded administration of either intravenous acetaminophen 1 g or ketorolac 30 mg intra-operatively. Upon arrival but before premedication, baseline pain scores were assessed in all patients. A consecutive series of postoperative pain scores were collected every 15 min using a 10 cm visual analog pain scale (VAS) upon arrival to the post anesthesia care unit (PACU) until discharge by blinded study personnel. Other data collected included: anesthesia time, surgical time, time to discharge, supplemental morphine and postoperative side effects. Results: Overall mean postoperative VAS scores were not significantly different between the two treatment groups (p = 0.07). However, ketorolac produced significantly lower pain scores compared with acetaminophen in the later postoperative periods (3.9 ± 1.9 vs. 4.8 ± 2.4 at 45 min, p = 0.009; 3.4 ± 1.7 vs. 4.5 ± 2.1 at 60min, p = 0.04; and 3.2 ± 2.1 vs. 4.4 ± 2.1 at 75 min, p = 0.03). Supplemental morphine was administered to 3 patients in the ketorolac group and 9 patients in the acetaminophen group but total consumption was not significantly different between groups (p = 0.13). The occurrence of nausea was significantly lower in the ketorolac group compared with the IV acetaminophen group (3.4% vs. 14.6%, respectively; p = 0.02). The overall incidence of morphine supplementation, vomiting, headache, muscular pain, dizziness, and drowsiness were not significantly different when compared between the treatment groups. Conclusions: Both postoperative regimens provided adequate analgesia but patients receiving ketorolac intraoperatively had significantly lower pain scores at later recovery time points and significantly lower occurrences of nausea. Implications: The large volume of patients undergoing parathyroidectomies at our facility warranted a study to develop a standardized postoperative analgesic regimen. We conclude both medications can be utilized safely in this patient population, but there is a slight advantage in pain control with the usage of ketorolac for minimally invasive parathyroidectomies.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Intravenous acetaminophen vs. ketorolac for postoperative analgesia after ambulatory parathyroidectomy ; volume:4 ; number:4 ; year:2013 ; pages:249-253 ; extent:5 ; Scandinavian journal of pain ; 4, Heft 4 (2013), 249-253 (gesamt 5)

Contributors, Places and Time

• Creator: Anand, Amrat ; Sprenker, Collin J. ; Karlnoski, Rachel ; Norman, James ; Miladinovic, Branko ; Wilburn, Bruce ; Southall, Roger A. ; Mangar, Devanand ; Camporesi, Enrico

Further information

• DOI: 10.1016/j.sjpain.2013.06.001
• URN: urn:nbn:de:101:1-2024022314145480230714
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 14.08.2025, 10:51 AM CEST