# Local ketorolac infiltration for postoperative pain in open trigger finger surgery: a randomized controlled trial

## TL;DR

This study compares local ketorolac infiltration with oral ibuprofen for managing postoperative pain after trigger finger surgery, finding that ketorolac provides better pain relief in the first 6 hours.

## Contribution

The study demonstrates that local ketorolac infiltration improves early postoperative pain control compared to oral NSAIDs in trigger finger surgery.

## Key findings

- Local ketorolac infiltration significantly reduced pain scores during finger movement within 6 hours post-surgery.
- There were no significant differences in DASH scores, grip strength, or PIP joint mobility between groups.
- Combining ketorolac with oral ibuprofen did not provide additional benefits over ketorolac alone.

## Abstract

Multimodal analgesia is crucial for effective postoperative pain management in minor hand surgeries, enhancing patient satisfaction. The use of local wound infiltration with Ketorolac as an adjuvant pain management strategy is proposed for open trigger finger release surgery. This study aims to compare pain scores and functional outcomes between local wound infiltration with Ketorolac and oral non-steroidal anti-inflammatory drugs.

This study is a double-blind, parallel design, randomized controlled trials. Sixty-nine patients underwent trigger finger surgery between December 2021 and October 2022 were randomized into one of three groups: oral Ibuprofen alone group, local Ketorolac alone group and local Ketorolac with oral Ibuprofen group. The assessment included postoperative numeric rating scale (NRS) pain score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, grip strength, mobility of proximal interphalangeal (PIP) joint. and complications.

NRS pain scores during movement of the operated fingers were significantly lower at 6 h in local Ketorolac alone group and local Ketorolac with oral Ibuprofen group compared to oral Ibuprofen alone group. However, there were no significant differences between the groups in postoperative DASH scores, grip strength, mobility of PIP joints, and complications.

Local infiltration of Ketorolac as an adjunct in postoperative pain management has been shown to provide superior analgesia during finger movement within the initial 6 h following trigger finger surgery, in comparison to oral NSAIDs.

Thaiclinicaltrials.org identifier: TCTR20210825002. Registered 25/08/2021. https://www.thaiclinicaltrials.org/show/TCTR20210825002