Background: NSAID (Non steroid anti inflammatory drug ) inhibit cyclooxygenase enzyme and also inhibition of  proinflamation prostaglandin (PG). Ketorolac has recommended for a short time use on post operation, not longer than 2 days intravenous administration. So this drugs is good for acute analgesia.  The research useful for looking an effect of ketorolac administration as a preventive analgesia concern to pupil in prevent myosis in eye’s surgery within general anesthesia.

Methods: it was a quasi experimental study done in Sumatera Eye Centre Hospital, Medan, Indonesia during January to June 2012. Sampling was taken using total sampling method with 44 patients.

Results: There is no significant difference in myosis for patient with ketorolac as preventive analgesia in eye surgery

Keywords: ketorolac, preventive, analgesia, eye surgery, general anesthesia

1.      Hausser MW, Valley RD, Bailey AG. Anesthesia for pediatric   ophthalmology    surgery. In: Smith, editor. Textbook of anesthesia for   infants and children. Philadelphia: Mosby Elsevier; 2006, 770-88.

2.      Aitkenhead AR, Rowbotham DJ, Smith G. Anesthesia for ophthalmic surgery. In: Aitkenhead AR, Rowbotham DJ, Smith G, editors. Textbook of anesthesia. 4^th ed. Edinburgh: Churchill Livingstone; 2001, 594-605.

3.      McGoldrick KE, Gayer SL. Anesthesia and the eye.,ln Barash DG, Cullen BF, Stuelting RK, editors. Textbook of clinical anesthesia. 5^th ed. Philadelphia: Lippincott Williams & Wilkins; 2006, 974-96.

4.      Heon E, Levin AV, Lam WC. Ophtahlamic surgery: surgical consideration. In: Bissonette B, Dalens BJ, editors. Textbook of anesthesia principles and practice. New York: McGraw Hill; 2002, 1259-76.

5.      Morgan GE, Mikhail MS, Murray MJ. Anesthesia for ophthalmic surgery. In: Morgan GE, Mikhail MS, Murray MJ, editors. Textbook of clinical anesthesiology. 4^th ed. New York: Lange Medical Book; 2006, 826-36.

6.      Stephen J.Kim,etc.Topical Ketorolac in Vitreoretinal Surgery,a prospective,randomized,placebo-controlled,double-masked Trial.Arch Ophthalmol.2008;126(9):1203-8

7.      Yusuf M Suleiman,Najwa F.K,Aksam J.A.Comparison of Ketorolac Tromethamine and Prednisolone Acetate in Preventing Surgically Induced Miosis during Cataract Surgery.Squ Med J.2010;10:57-63

8.      Munish A,Avinash S.D,Surendra K.S,Dipak K.M.Topical Ocular Delivery of NSAIDs.The AAPS Journal.2008;10:no 2.

9.      Robert Stewart,Robert G,Janet K,Allan R.Efficacy and safety profile of ketorolac 0,5% ophthalmic solution in the prevention of surgically induced miosis during cataract surgery.clinical Therapeutics.vol 21;4:723-32

10.  Richard Atanis,etc.Effect of topical ketorolac tromethamine and topical nepafenac on maintaining pupillary dilation during phacoemulsification.Philippine Journal of Ophthalmology.2011;36(1):23-7.

11.  Cousins M. Acute and postoperative pain In :  Melzack R, Wall PD. Editors. Handbook of pain management a clinical companion to wall and melzack’s textbook of pain. London : churchill Livingstone ; 2003,p.13-30.

12.  Provenzano DA, Grass JA. Is epidural Analgesia superior to iv PCA?. In: Fleisher LA, editors. Evidence-Based Practice of Anesthesiology Philadelphia; Sauders;2004, p.442-4.

13.  Basuki G.Peran Ketorolak pada pengelolaan nyeri paska bedah.In: Buku kumpulan makalah KONAS Indonesian Pain Society.Makassar.2002.p 66-68

14.  Stoelting RK. Prostaglandins. In : Stoelting RK, eds. Pharmacology and Phisiology in Anaesthetic Practice. Philadelphia : Lippincott, 1991: p. 384-91.

15.  28. Kelly DJ. Ahmad M. Sorin J. Brull MD. Preemptive analgesia II: recent advances and current trens. Can J Anest 2001;48(11): p.1091-1101

16.  Dekens J. Lepointe F, Besserve P. Analgesia Post Operatoire en   Chirurgie Osteoarticulaire par Le Ketoprofene en Perfusion. Cahaiers d’Anesthesiologie, Janvier-Fevrier, 1988; 36: p.25-7.

17.  Guadalupe C,etc.Inhibition of Surgically induced miosis and prevention of postoperative macular edem with nepafenac.Clinical Ophtalmology,2009:p.219-26

Andriamuri Primaputra Lubis

Senior Consultant, Department of Anesthesiology & Intensive Therapy,

Faculty of Medicine, University of Sumatera Utara, Medan, Indonesia