Efficacy of ketorolac versus tramadol for analgesia during percutaneous vertebroplasty

Objective To evaluate the efficacy of ketorolac versus tramadol used in analgesia during percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fracture(OVCF). Methods This retrospective study selected 126 patients who underwent PVP for treatment of osteoporotic vertebral compression fracture. Among them, there were 35 males and 91 females, with an age range of 60-82 years and an average age of 71.2±6.5 years old. The patients were divided into two groups: ketorolac group and tramadol group. Operation time and analgesic consumption of the two groups were recorded and compared; The mean artery pressure (MAP) and heart rate (HR) were recorded at following times point: entering operation room (T0), beginning of surgery (T1), injection of bone cement into the vertebral body (T2), ending of surgery (T3); pain visual analogue scale (VAS) were recorded at admission, after analgesic medication, intraoperative maximum, at discharge and 1 year after surgery; Oswestry disability index (ODI) 1 year after surgery, satisfaction scores of patient, adverse events happened intraoperatively and postoperatively were also collected for comparison. Results There was no difference in general data between the two groups. The values of HR and MAP at T1, T2 and T3 were significantly lower in the ketorolac group compared to tramadol group (P＜0.05); No difference in VAS scores between the two groups of patients was observed at admission, discharge, and follow-up. Ketorolac group showed significantly lower VAS scores than tramadol group after analgesic medication and during surgery (P＜0.05); There was no difference in the treatment course of preoperative analgesics between the two groups. The dosage of intraoperative analgesics in ketorolac group was significantly lower than that in tramadol group, and the difference was statistically significant (P＜0.05). The operation time in the ketorolac group was significantly shorter than that in tramadol group, and patient satisfaction was significantly higher than that in tramadol group(P＜0.001). There was no difference in pre-operative and post-operative ODI scores between the two groups. The incidence of post-operative nausea was significantly lower in ketorolac group than in the tramadol group(P＜0.05). Conclusions Ketorolac can effectively shorten operation time, reduce the pain intensity of patients with osteoporotic vertebral compression fracture, and can decrease the occurrence of postoperative nausea and improve patient satisfaction.