Tramadol Ketorolac

Intravenous tramadol 1.5 mg/kg has been compared with a single dose of intravenous ketorolac 10 ng in 60 patients scheduled to undergo day-case laparoscopic sterilization in a prospective, randomized, double-blind comparison (11). Tramadol was associated with significantly less postoperative pain. There was no difference in the incidence or severity of nausea and vomiting between the two groups. Dry mouth was significantly more common with tramadol (60 versus 27%). 

In a randomized, double-blind placebo-controlled study of 76 women undergoing abdominal hysterectomy, tramadol 100 mg was a more effective analgesic than ketorolac 30 mg given every 6 hours intravenously (45). However, of those given tramadol 38% had vomiting compared with only 8% of those who were given ketorolac. 

Putland AJ, McCluskey A. The analgesic efficacy of tramadol versus ketorolac in day-case laparoscopic sterilisation. Anaesthesia 1999 54(4) 382-5. 

Ketorolaco frente a tramadol estudio comparative de la eficacia analgesica en el dolor postoperatorio de histerecto-mias abdominal. [Ketorolac versus tramadol comparative study of analgesic efficacy in the postoperative pain in abdominal hysterectomy.] Rev Esp Anestesiol Reanim 2000 47(4) 162-7. 

NSAIDs are often administered with opioids because they usually reduce the opioid requirements and some of the opioid-induced Averse effects. Enhanced pain relief has been reported with various combinations including dextromethorphan with ketorolac or tenoxicam, oxycodone with ibuprofen, and tramadol with ketorolac without increased adverse effects. See also coxibs , (p.l79). However, cases of respiratory depression have been reported, see Morphine below. Myoclonus has been reported with high does of morphine administered with NSAIDs, see C3pioids Morphine + Miscellaneous , p.l90. 

Lepri A, Sia S, Catinelli S, Casali R, Novell G. Patient-controlled analgesia with tramadol versus tramadol plus ketorolac. Minerva Anestesiol (2006) 72, 59-67. 

---