• M L Gora-Harper, K E Record, T Darkow, and P A Tibbs.
• Drug Information Center, College of Pharmacy and Hospital, University of Kentucky, Lexington, USA. mharp1@pop.uky.edu
• Ann Pharmacother. 2001 Nov 1;35(11):1320-6.

BackgroundKetorolac's efficacy as a postoperative analgesic has been shown to be comparable to that of narcotic analgesics, but with significantly fewer narcotic-related adverse events.ObjectiveTo assess whether the choice of postoperative analgesic, narcotic or ketorolac, has an impact on healthcare resource utilization and cost durng inpatients' recovery period.DesignRetrospective, multicenter, controlled, parallel, cost-minimization analysis.SettingSix US teaching hospitals.PatientsThis study included 559 patients that underwent either a spine or joint procedure and received adequate doses of narcotic (n = 284 of either morphine or meperidine) or ketorolac (n = 275).MeasurementsTime to reach recovery milestones, average utilization of healthcare resources, and average per-case postoperative treatment cost.ResultsSeveral recovery milestones, including time to first bowel movement, first oral intake, and first unassisted ambulation, were reached sooner in the ketorolac group, with a resultant shorter mean length of postoperative stay (narcotic 3.78 d, ketorolac 2.80 d; p = 0.01). Total per-patient cost of treatment was 32% greater in the narcotic group, resulting primarily from higher costs associated with hospitalization.ConclusionsDespite the higher acquisition cost of medication, healthcare resource utilization and total per-patient cost of treatment were lower for patients in the ketorolac group compared with patients in the narcotic analgesic study group. The majority of patients in the ketorolac group were also given concurrent narcotic analgesics; therefore, the beneficial effects observed may be secondary to the combination of ketorolac and narcotic analgesics.

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