Ketorolac plus Lidocaine vs Lidocaine for pain relief following core needle soft tissue biopsy A CONSORT-compliant double-blind randomized controlled study

Backgrounds: The main objective of this study was to compare the pain control efficacy of local administration of Lidocaine with or without the nonsteroidal anti-inflammatory drug, Ketorolac, and local conventional Lidocaine injection in core needle biopsy of the musculoskeletal tumor. Methods: The current study was a randomized, double-blind controlled clinical trial that included 128 patients with suspected musculoskeletal tumors. Patients were randomly assigned to either the Ketorolac plus Lidocaine (n=64) or Lidocaine group (n=64). The Ketorolac - Lidocaine combination syringe contained 30mg Ketorolac and 2% Lidocaine - adrenaline dosage, and the Lidocaine syringe contained 2% Lidocaine - adrenaline dosage. The level of pain after core needle biopsy was evaluated for each patient at 1, 6, 12, 24, 48, and >48hours by a Visual Analog Scale (VAS). The mean VAS changes over time were compared between the Ketorolac plus Lidocaine and Lidocaine groups using a linear mixed model. Results: baseline information including mean age of patients in Lidocaine group (51.5 +/- 19.4 years) and in Lidocaine - Ketorolac combination group (50.1 +/- 18years), diagnosis (malignant, benign, metastatic, infection), tumor location (upper and lower extremities, back), VAS score 1-hour post-operation (mild and moderate pain) were noted. The VAS score ratings were significantly lower in Lidocaine - Ketorolac combination group when compared to the Lidocaine group during the 1 to 24hours post-operation time period. Conclusion: Patients receiving Lidocaine - Ketorolac combination dosage had significantly lower VAS scores, and these results confirm that local injection of Lidocaine - Ketorolac combination had a superior pain-controlling effect during the first 24hours after the biopsy procedure in comparison to Lidocaine injection alone, as measured by VAS score scale.