Pharmacotherapy
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Randomized Controlled Trial Comparative Study Clinical Trial
Evaluation of ketorolac, aspirin, and an acetaminophen-codeine combination in postoperative oral surgery pain.
One-hundred twenty-eight outpatients with postoperative pain after the surgical removal of impacted third molars were randomly assigned, on a double-blind basis, to receive oral doses of ketorolac tromethamine 10 mg, aspirin 650 mg, a combination of acetaminophen 600 mg plus codeine 60 mg, or placebo. Using a self-rating record, subjects rated their pain and its relief hourly for 6 hours after medicating. All active medications were significantly superior to placebo. ⋯ Repeat-dose data also suggested that ketorolac 10 mg was superior to aspirin 650 mg and acetaminophen-codeine on the day of surgery. Differences among the active medications were trivial for the postoperative days 1-6 analyses. The frequency of adverse effects was over 4 times greater for acetaminophen-codeine than for ketorolac or aspirin.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of repeat doses of intramuscular ketorolac tromethamine and morphine sulfate for analgesia after major surgery.
A multicenter, randomized, double-blind, parallel study in 542 patients with moderate or severe postoperative pain compared the analgesic efficacy and safety of intramuscular ketorolac 30 mg (324 patients), morphine 6 mg (110 patients), and morphine 12 mg (108 patients) administered as needed as often as every 2 hours for a maximum of 20 doses or 5 days. The efficacy of ketorolac 30 mg was comparable to that of morphine 12 mg on every efficacy measure (average pain intensity, average pain relief, mean overall medication rating, and percentage of patients withdrawing because of inadequate relief). Ketorolac was statistically superior to morphine 6 mg for average pain intensity and mean overall rating. Ketorolac-treated patients had fewer adverse events than those who received either morphine dose.
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Randomized Controlled Trial Comparative Study Clinical Trial
Analgesic efficacy and safety of single-dose oral and intramuscular ketorolac tromethamine for postoperative pain.
The efficacy and safety of the analgesic drug ketorolac tromethamine in the treatment of moderate to very severe postoperative pain was assessed in five dose-ranging studies with single-dose, double-blind, randomized, parallel-group designs. The drug was administered orally (2.5-200 mg, 352 patients in three trials) and intramuscularly (5-90 mg, 395 patients in two trials), and compared with placebo and reference drugs. Patients subjectively evaluated pain intensity and relief using verbal categoric and visual analog scales; efficacy values included pain intensity difference (PID), summed PID, and total pain relief. ⋯ Intramuscular ketorolac 10 and 30 mg were superior to intramuscular meperidine 50 and 100 mg. Ketorolac was well tolerated, with rates of adverse events generally lower than those of the opiate comparators. Ketorolac doses of 2.5 and 5 mg were less effective than higher doses; 10 mg or more resulted in faster onset of action and greater peak efficacy; 90 mg or more gave more prolonged analgesic effects.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Intramuscular ketorolac and morphine in the treatment of moderate to severe pain after major surgery.
A multicenter, randomized, open, parallel study in 227 patients with moderate or severe postoperative pain compared the analgesic efficacy and safety of multiple intramuscular injections of ketorolac 30 mg (184 patients) and morphine 10 mg (43 patients) administered as needed as often as every 2 hours for a maximum of 40 doses or 10 days. Supplemental standard analgesics, usually opiates, were permitted if additional pain medication was required. ⋯ Given alone or with supplemental analgesics, ketorolac was better tolerated than morphine, as reflected by rate of terminations due to adverse events and frequency of common complaints. Intramuscular ketorolac thus provides an important additional approach to management of pain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intravenous ketorolac tromethamine versus morphine sulfate in the treatment of immediate postoperative pain.
Intravenous ketorolac tromethamine was compared with morphine sulfate for the relief of moderate to severe postoperative pain and for side effects in 125 women undergoing major abdominal gynecologic surgery. Patients were randomly assigned to receive an initial intravenous dose of ketorolac 10 mg, ketorolac 30 mg, morphine 2 mg, or morphine 4 mg, administered in a double-blind fashion. No other narcotics were administered in the 3 hours preceding the first dose of study drug. ⋯ With the dosage regimens used, neither drug adequately controlled moderate to severe pain in the immediate postoperative period. Patients receiving ketorolac experienced significantly less drowsiness than those given morphine, and some subjects in each experienced nausea. No serious adverse effects were reported.