背景：子宮收縮痛是剖腹產後常見的疼痛，而Ketorolac可以舒緩子宮收縮痛。所以這個研究是設計用來評估剖腹產後的患者使用Ketorolac加上低劑量opioids與單獨使用opioids兩者之間，在止痛效果與副作用方面的差別。方法：手術後接受靜脈患者自控式術後止痛的剖腹產孕婦，隨機分成(A) ketorolac (1.03 mg/ml) +fentanyl (4.31μg/ml) +morphine (0.172 mg/ml), (B) fentanyl (15μg/ml) +morphine (0.5 mg/ml)兩組，疼痛度以verbal rating scale (VRS) 0-4分（從完全不痛至完全無法忍受）來分級。並且記錄在術後72小時內發生的副作用。結果：在VRS score，比較Group A (0.54±0.51)和B (0.91±0.61)，兩組在第一天沒有差異存在，(P>0.05)第二及第三天也沒有差異。副作用如昏睡、頭暈、（口惡）心、嘔吐和皮膚癢在Group B發生率較高，在昏睡、頭暈、（口惡）心和嘔吐的發生率有統計上的差異。而在皮膚癢方面則無統計上之差異。結論：從研究的結果，我們認為Group A和Group B提供相同的止痛效果，雖然ketorolac有減少使用opioids劑量的效果，但是卻沒有明顯改變止痛的效果。有關副作用發生方面Group A比Group B提供較好的結果。所以我們建議假如沒有其他非類固醇類消炎藥使用的禁忌，ketorolac可以用來取代一些opioids來作為術後止痛使用。
Background: Ketorolac is known to be effective in releasing uterine cramping pain common in post cesarean section patients. This study was designed to compare the analgesic effects and adverse effects of ketorolac plus low dose opioids as opposed to opioids alone in patients receiving intravenous patient-controlled analgesia after cesarean section. Methods: Patients who received postoperative intravenous patient-controlled analgesia were randomly assigned to two groups: (A) ketorolac 1.03 mg/ml) +fentanyl (4.31 μg/ml) +morphine (0.172 mg/ml), (B) fentanyl (15 μg/ml) +morphine (0.5 mg/ml). During the postoperative 72-hour period pain intensity was evaluated with verbal rating scale (VRS) on a scale of 0-4 (from "none" to "excruciating"), and side effects were recorded. Results: No statistical difference (P>0.05) was found in VRS scores. Significantly higher side effects were found in Group B (drowsy, dizziness, nausea, vomiting). Conclusions: The ketorolac group (Group A) received the same postoperative analgesic effect, on lower dosage opiates and with lower side effects than the opiate group (Group B). We suggest use of ketorolac to replace some opioids for postoperative analgesia when no contraindications for NSAID5 use are present.
