• D A O'Hara, G Fanciullo, L Hubbard, T Maneatis, P Seuffert, L Bynum, and A Shefrin.
• Department of Anesthesia, Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
• Pharmacotherapy. 1997 Sep 1;17(5):891-9.

Study ObjectiveTo compare ketorolac tromethamine with morphine for pain management after major abdominal surgery.DesignDouble-blind, randomized study.SettingHospital recovery room and postoperative surgical unit.PatientsOne hundred ninety-one patients with at least moderate pain after major abdominal surgery.InterventionsPatients received ketorolac by patient-controlled analgesia (PCA) bolus alone (Ket B), ketorolac by bolus plus infusion (Ket I), or morphine by PCA bolus (morphine), with injectable morphine available for supplementation.Measurements And Main ResultsLevels of sedation, pain intensity, pain relief, and adverse events were recorded at baseline, at 2, 4, and 6 hours, and at termination. Supplemental morphine was required by 71% of Ket B patients, 67% of Ket I patients, and 38% of morphine patients (p < or = 0.001 for Ket B vs morphine). Although patients receiving ketorolac required more supplemental morphine than the morphine group (6.0 mg Ket I, 6.2 mg Ket B, 4.0 mg morphine), there was a large morphine-sparing effect in both ketorolac groups (total morphine 6.0 mg Ket I, 6.2 mg Ket B, 33.3 mg morphine). Overall pain relief scores were similar for morphine and Ket I groups, and were lower for Ket B than for morphine (p = 0.002). There were no differences among groups in numbers of patients with adverse events.ConclusionKetorolac may be effective when administered by PCA device, and has a clear morphine-sparing effect.

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