• R Casali, G Girardi, R D Mediati, P Livi, and G P Novelli.
• Istituto di Anestesiologia e Rianimazione, Università degli Studi-Firenze.
• Minerva Anestesiol. 1995 Dec 1; 61 (12): 501-7.

BackgroundThe aim of the study is to determine what concentration of ketorolac and morphine administered together i.v. achieve best synergic effect between NSAID antiinflammatory and opioids analgesic properties.DesignRandomized comparative study was carried out on 180 patients, ASA II-IV, undergoing major general surgery, in an University Clinic.MethodsPostoperative pain therapy by i.v. PCA: group 1 morphine 0.75 mg.ml + ketorolac 0.75 mg.ml; group 2 morphine 0.50 mg.ml + ketorolac 1.50 mg.ml; group 3 morphine 0.25 mg.ml + ketorolac 1.50 mg.ml; in saline solution. Initial bolus: 2 ml. Continuous infusion 1.5 ml.h. Demand bolus: 0.2 ml. Lockout time: 30 minutes. Evaluations included: pain intensity (T0, T3, T18); total amount of infused drugs (T18); number of valid demands and attempts (T18); amount of autoadministered analgesic drugs in percent of highest available amount (T18); side effects (T18); patient's judgment.Data AnalysisANOVA and Student's "t"-test.ResultsA statistically significant reduction of pain intensity was found after 3 and 18 hours in the three groups, no differences were found among the groups. Group 2 required an amount of autoadministered drugs significantly lower than other groups. Rare side effects. Patient's judgment was generally positive.ConclusionsResults suggest a greater synergetic effect between morphine and ketorolac in concentrations used in group 2.

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