Postoperative pain management with ketorolac in facial plastic surgery patients.

[OBJECTIVE] To evaluate the benefit of intraoperative locally or intramuscularly injected ketorolac in combination with local anesthetic versus local anesthetic alone on postoperative pain in patients undergoing facial plastic surgery.

[METHODS] Prospective randomized trial of 140 consecutive patients undergoing facelift, and/or forehead lift at a private facial cosmetic surgery practice by one surgeon. Outcome measurement included the requirement for pain medication (none, morphine, acetaminophen with codeine, or plain acetaminophen) at 1, 12, and 24 hours postoperatively.

[RESULTS] Ninety-five patients receiving locally injected ketorolac required significantly less postoperative analgesic (p<.05) than both the 20 patients who received intramuscularly injected ketorolac and the 25 patients who received local anesthetic alone at 12 and 24 hours. Those patients receiving no ketorolac required significantly more (p<.05) analgesic 1 hour postoperatively.

[CONCLUSION] Intraoperative locally injected ketorolac is an effective and safe means of reducing postoperative analgesic requirements.