POSTOPERATIVE PAIN RELIEF FOLLOWING INGUINAL HERNIOPLASTY: A RANDOMIZED CONTROLLED TRIAL COMPARING INTRAVENOUS KETOROLAC AND TRAMADOL

Background: Postoperative pain management is critical for recovery following inguinal hernioplasty. Tramadol, a commonly used opioid analgesic, is associated with side effects such as nausea, vomiting, and delayed bowel function. Ketorolac, a non-steroidal anti-inflammatory drug (NSAID), offers a potential alternative with fewer adverse effects. This study aimed to compare the analgesic efficacy and safety of intravenous ketorolac versus tramadol in patients undergoing elective open inguinal hernioplasty. Methods: In this prospective, randomized, double-blinded trial, 60 adult patients undergoing elective open inguinal hernioplasty under spinal anaesthesia were assigned to two groups: Group K received ketorolac 30 mg IV every 8 hours, and Group T received tramadol 50 mg IV every 8 hours. Pain was assessed using the Visual Analog Scale (VAS) at 2, 6, 12, and 24 hours postoperatively. Secondary outcomes included time to rescue analgesia, ambulation, and first flatus. 

Results: The ketorolac group had significantly lower VAS scores at all time points (p < 0.05), required less rescue analgesia, and showed faster recovery, with earlier ambulation and bowel function return. Postoperative Hemodynamic stability was maintained in both groups. 

Conclusion: Intravenous ketorolac provides superior analgesia and enhanced recovery compared to tramadol, making it an effective opioid-sparing option for postoperative pain management in inguinal hernioplasty. Key words: Inguinal hernioplasty, ketorolac, tramadol, randomized controlled trial, Visual Analog Scale, recovery outcomes.