Comparing the sedative and analgesic effects of ketorolac and diclofenac eye drops among patients with cataract surgery: A double-blind randomized clinical trial.

Abstract

Aim: The aim of this study was to compare the sedative and analgesic effects of ketorolac and diclofenac eye drops among patients with cataract surgery (CS) who received tetracaine.

Methods: This double-blind randomized clinical trial was conducted in 2022. Participants were the candidates for CS consecutively selected from Amirkabir hospital, Arak, Iran, and were assigned to an artificial tear group, a ketorolac group, and a diclofenac group through block randomization. Pain, sedation status, heart rate, blood pressure, and arterial oxygen saturation were assessed during and after surgery. Complications prevalence and intraoperative propofol use were also documented. Data were analyzed using the SPSS software (v. 20.0) at a significance level of <0.05.

Results: There were no significant differences among the study groups respecting participants' age, gender, body mass index, blood pressure, heart rate, arterial oxygen saturation, CS duration, and Aldrete score (P > 0.05). From 5 min after CS onward, the mean score of pain in the ketorolac group was significantly less than the other groups (P < 0.05). The mean score of sedation from recovery to 1 h after surgery in the artificial tear group was significantly more than the other groups, whereas the mean score of sedation 2 and 4 h after CS in the ketorolac group was significantly more than the other groups (P < 0.05). Propofol use in the artificial tear group was significantly more than in other groups (P = 0.001) and patient and surgeon satisfaction in this group was significantly less than in other groups (P < 0.05). The ketorolac and the diclofenac groups did not significantly differ from each other respecting surgeon and patient satisfaction and the prevalence of complications (P > 0.05).

Conclusion: Ketorolac eye drops are more effective than diclofenac eye drops in significantly reducing intraoperative pain among the candidates for CS with topical anesthesia. Therefore, ketorolac eye drops can be used with tetracaine eye drops in CS with topical anesthesia to produce greater perioperative analgesia and sedation.