Comparing the Postoperative Analgesic Efficacy of Ketorolac and Tramadol After Open Inguinal Hernia Mesh Repair: A Randomized Controlled Trial

Background Opioids are the mainstay for postoperative pain control. However, due to the increasing dependence on opioids and their side effects, multiple adjuncts are used to reduce opioid consumption, including non-steroidal anti-inflammatory drugs (NSAIDs). Inguinal hernia repair is one of the most common procedures performed by general surgeons worldwide. Despite various advancements in operative techniques, postoperative pain remains a major risk factor for morbidity and delayed hospital discharge following surgery. Objective The objective of this study was to compare ketorolac with tramadol for postoperative pain control following open inguinal hernia mesh repair. Methods This was a randomized controlled trial. Sixty patients undergoing unilateral primary open inguinal hernia repair with mesh were randomly divided into two groups: Group A received injection ketorolac intravenously postoperatively, while Group B received injection tramadol intravenously following surgery. Pain scores and vitals were measured at two, six, 12, and 24 hours post procedure. Other secondary outcomes included the time for nausea to stop, time to pass flatus, and time to start ambulation. Data was analyzed by independent-sample t-test using IBM SPSS Statistics for Windows, Version 30.0 (Release 2024; IBM Corp., Armonk, New York, United States); a p-value of < 0.05 was considered significant. Results Pain scores were lower in the ketorolac group when compared to tramadol. However, patients in the tramadol group had nausea for a longer duration, delayed return of bowel function, and took longer to start ambulation. There was no significant difference in vitals. Conclusion Injection ketorolac, when used in isolation, provides more effective postoperative analgesia along with fewer side effects when compared to tramadol in inguinal hernia repair.