A comparative study of ketorolac vs dexmedetomidine to attenuate tourniquet induced cardiovascular response in lower limb surgery
Abstract
Background & Aims: This prospective, randomized, double-blind study was undertaken to compare the effect of ketorolac or dexmedetomidine to attenuate tourniquet induced rise in blood pressure and heart rate in lower limb orthopedic surgery under general anesthesia.
Methodology: One hundred, American Society of Anesthesiologist class I and II patients for elective lower limb surgery under general anesthesia were enrolled, to receive either 30 mg ketorolac (Group KL) or 0.5 µg/kg dexmedetomidine (Group DX) intravenously before inflation of tourniquet. Systolic blood pressure, diastolic blood pressure and heart rate were recorded before induction of anesthesia and at 0, 15, 30, 45, 60 and 75 min after tourniquet inflation, just before tourniquet deflation and at 15 min after tourniquet deflation. Incidence of tourniquet induced hypertension, postoperative analgesic requirements, patient satisfactory score and any side effects were also recorded.
Results: Systolic blood pressure, diastolic blood pressure and heart rate significantly increased at 45, 60, 75 min after tourniquet inflation and just before tourniquet deflation in ketorolac group as compared to dexmedetomidine group (P < 0.05). Incidence of tourniquet induced hypertension was more with ketorolac than with dexmedetomidine (P=0.01). The total diclofenac consumption during first 24 hrs of postoperative period was significantly less with ketorolac compared to dexmedetomidine (P=0.001).
