Effect of Ketorolac and Nimesulide Combination on Surgical Pain, Stomach and Kidneys

Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID). Cyclooxygenase-2 (COX-2) inhibition from the therapeutic effects of NSAIDs and COX-1 inhibition from toxic effects are held responsible. It is known that nimesulide has formed a protective effect by inhibiting the decrease in COX-1 activity and the increase in COX-2 activity. In this study animals were divided into healthy (HG), paw-scalpel incision (PSI) control (PSIC), PSI+nimesulide (PSIN), PSI+ketorolac (PSIK), and PSI+nimesulide+ketorolac (PSI+NKC) administered groups. Nimesulide was administered orally(50 mg/kg), and ketorolac was administered intra-peritoneally(5 mg/kg). Nimesulide and ketorolac showed similar analgesia (p = 0.194), while NKC provided the best analgesia (p < 0.001). Nimesulide inhibited the increase of oxidant and COX-2 in gastric tissue and increased antioxidant and COX-1 levels, protecting the stomach tissue from ketorolac damage(p < 0.01). In addition, NKC reduced the area and number of ketorolac-induced gastric ulcers in the stomach (p<0.001). Nimesulide also prevented ketorolac-induced renal dysfunction (p < 0.001). © 2023, Colegio de Farmaceuticos de la Provincia de Buenos Aires. All rights reserved.