• T R Vetter and E J Heiner.
• Department of Anesthesiology, Children's Hospital Medical Center, Akron, OH.
• J Clin Anesth. 1994 Mar 1;6(2):110-3.

Study ObjectiveTo assess the effects of a single intraoperative dose of intravenous (i.v.) ketorolac on postoperative opioid dose requirements, quality of analgesia as assessed by the patient, and frequency of opioid-related side effects during pediatric patient-controlled analgesia (PCA) with morphine.DesignProspective, randomized, double-blind study.SettingOperating rooms, postanesthesia care unit (PACU), and inpatient care units of a freestanding children's hospital.Patients50 ASA physical status I-II orthopedic surgical patients ages 8 to 16 years.InterventionsEither 0.8 mg/kg of i.v. ketorolac or no additional analgesic was administered at the time of wound closure. After surgery, all patients were placed on PCA with morphine.Measurements And Main ResultsIndividual morphine use during the first 12 hours of PCA therapy was recorded. A visual analog scale (VAS) pain score was obtained from the patient at the time of discharge from the PACU and at 4, 8, and 12 hours postoperatively. Any vomiting, pruritus, or urinary retention occurring during the first 12 postoperative hours was noted. The morphine plus ketorolac group administered significantly less PCA with morphine during the first 12 postoperative hours than did the morphine only group (p = 0.002). The morphine plus ketorolac group also reported significantly lower overall VAS pain scores (p < 0.01). Although similar frequencies of vomiting and pruritus were observed, the morphine plus ketorolac group experienced significantly less urinary retention than did the morphine group (p = 0.02).ConclusionA single intraoperative dose of i.v. ketorolac appears to be opioid dose sharing, to provide superior analgesia, and to decrease the frequency of urinary retention during the first 12 hours of postoperative pediatric PCA with morphine.

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