Effect of ketorolac on pain, opioid use, and recovery after lumbar surgery

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Created On: 27/11/2025

Ketorolac, a highly potent nonsteroidal anti-inflammatory drug (NSAID), is frequently administered during spine surgeries.

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Key take away

Ketorolac use during lumbar surgery does not significantly change postoperative pain scores, opioid consumption, or hospital stay duration, but notably decreases the incidence of nausea and vomiting—supporting its role as a safe and effective adjunct for postoperative recovery.

Background

Ketorolac, a highly potent nonsteroidal anti-inflammatory drug (NSAID), is frequently administered during spine surgeries. This study sought to determine how ketorolac use—alone or in combination with other medications—impacts postoperative recovery outcomes following lumbar surgery.

Method

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted via PubMed, CINAHL, MEDLINE, and Web of Science databases as of July 2023. Studies were included if they explored the effects of ketorolac in patients undergoing lumbar surgery.

Result

Overall, 13 RCTs comprising 997 subjects (mean age 54.6 ± 7.8 years; 535 in the ketorolac group) met the inclusion criteria. No prominent differences were noted between ketorolac and non-ketorolac groups in 24-hour morphine consumption (P = 0.185), total postoperative morphine use (P = 0.109), 24-hour or final pain scores (P = 0.065 and P = 0.582, respectively), or hospital length of stay (P = 0.990).

Major (3.7% vs. 5.4%) and minor (42.1% vs. 51.7%) complication rates were comparable between the two groups. However, the ketorolac group experienced markedly fewer cases of postoperative nausea and/or vomiting as opposed to the non-ketorolac group (21.6% vs. 37.1%).

Conclusion

Ketorolac administration during lumbar surgery did not considerably influence postoperative morphine requirements, degree of pain, or hospital stay duration. Complication rates remained similar, although ketorolac use was linked with a lower incidence of nausea and vomiting.