The objective of this study was to compare the analgesic effectiveness between low-dose Ketorolac and Parecoxib subsequent to total knee arthroplasty (TKA).

This retrospective cohort study was executed with 200 subjects who underwent knee surgery. The participants were divided into two groups:

• Ketorolac Group (n=75): Intravenously received 15 mg of low-dose Ketorolac preoperatively and every 6 hours until 48 hours postoperatively
• Parecoxib Group (n=125): Intravenously received 40 mg Parecoxib preoperatively, and every 12 hours until 48 hours postoperatively

Pain scores, opioid consumption, and adverse events were assessed.

Superior results compared to Parecoxib were revealed by Ketorolac in this investigation. Patients administered Ketorolac reported notably reduced Visual Numeric Rating Scale (VNRS) scores at 8- and 20-hours post-surgery, as shown in Figure 1:

This pattern was additionally validated through linear mixed models (p = .0084). Furthermore, reduced opioid use during the initial 24 hours was associated with Ketorolac (Table 1).

Importantly, the incidence of adverse events showed no significant difference between the two groups.

Superior analgesic efficacy during the initial 24 hours after TKA was demonstrated by preemptive analgesia with low-dose Ketorolac compared to Parecoxib. These findings contribute to the increasing body of evidence indicating a potential analgesic ceiling effect with Ketorolac.