Pharmacotherapy
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of intravenous ketorolac tromethamine and morphine sulfate in the treatment of postoperative pain.
This study compared the efficacy and safety of ketorolac tromethamine and morphine sulfate in alleviating moderate or severe pain immediately after major surgery. One hundred twenty-two patients were randomly assigned to receive single intravenous injections of ketorolac 10 mg, ketorolac 30 mg, morphine 2 mg, or morphine 4 mg; patients could receive a second dose 15 minutes thereafter, upon request, and most received both available doses. Analgesic efficacy was measured by interviewing patients and assessing pain intensity and pain relief for 6 hours after the first medication administration. ⋯ One patient who took morphine 4 mg withdrew because of drowsiness; other common adverse events reported included nausea, vomiting, somnolence, and dyspepsia. There were no statistically significant differences in the frequency of adverse events among the treatment groups. Intravenous ketorolac is effective for the treatment of postoperative pain.
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Randomized Controlled Trial Clinical Trial
Evaluation of ketorolac, ibuprofen, acetaminophen, and an acetaminophen-codeine combination in postoperative oral surgery pain.
Two-hundred six 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 and 20 mg, ibuprofen 400 mg, acetaminophen 600 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 indicated that on the day of surgery ketorolac 10 and 20 mg and ibuprofen 400 mg were superior to acetaminophen 600 mg; ketorolac 20 mg was also superior to acetaminophen-codeine. Differences among active medications were not significant when data for the entire postoperative period (days 0-6) were evaluated. The frequency of adverse effects was similar for the active medications.
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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
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
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.