Pain management in outpatient urologic procedures: A prospective randomized trial of oxycodone versus ketorolac
Recommended Citation
Yu E, Chen M, Mahran A, et al. Pain management in outpatient urologic procedures: A prospective randomized trial of oxycodone versus ketorolac. International Journal of Reconstructive Urology. 2023;1(1):40-45. doi:10.4103/ijru.Ijru_4_23
Abstract
Objectives:The objectives of the study were to evaluate the efficacy of ketorolac for pain control compared to oxycodone after routine outpatient urologic procedures and to characterize medication overprescription and disposal.
Materials and Methods:A prospective randomized trial of 150 adults (75 in the ketorolac arm and 75 in the oxycodone arm) who underwent outpatient urologic procedures over 12 months was performed. Baseline and follow-up pain scores were elicited from 55 of these patients (30 ketorolac patients and 25 oxycodone patients), and improvement in pain scores was calculated. Wilcoxon rank-sum test was used to analyze changes in pain scores within and between groups. Pill disposal methods were also recorded.
Results:Pain significantly decreased in both oxycodone (5/10 at baseline and 3/10 at follow-up) and ketorolac (4/10 at baseline and 3/10 at follow-up) groups. No statistically significant differences in pain improvement were found between groups, despite patients in the oxycodone group taking a higher number of pills (one ketorolac pill vs. four oxycodone pills). A large portion of patients in both groups also did not fill their analgesics (14.7% of oxycodone and 38.7% of ketorolac). Patients in the oxycodone group were more likely to keep surplus pills than ketorolac patients (61.3% vs. 38.7%).
Conclusion:Ketorolac is a noninferior alternative to oxycodone following outpatient urologic procedures. Patient and physician education is necessary to curtail the indiscriminate prescription, use, and disposal of opioids.
Document Type
Article