Showing papers on "Ketorolac published in 1993"
TL;DR: Results of this study confirmed the trends of a previous study showing that ketorolac 0.5% ophthalmic solution applied topically is an effective therapy for allergic conjunctivitis.
99 citations
TL;DR: Although both ketorolac and dezocine were effective alternatives to fentanyl when administered during outpatient laparoscopy, deZocine was associated with an increased incidence of postoperative nausea and a delayed discharge time compared with ketorlac.
Abstract: The comparative effects of ketorolac, dezocine, and fentanyl were evaluated in 136 healthy female patients undergoing outpatient laparoscopic procedures according to a randomized, double-blind protocol. Patients received ketorolac (60 mg) or dezocine (6 mg) or fentanyl (100 micrograms, control group) before the start of the operation. A standardized general anesthetic technique consisting of midazolam (2 mg), fentanyl (50 micrograms), and propofol (2 mg/kg) for induction of anesthesia followed by propofol (120 micrograms.kg-1.min-1), vecuronium (1-2 mg), and 67% nitrous oxide in oxygen for maintenance of anesthesia, was used. In the postanesthesia care unit, 61% of patients in the fentanyl group received analgesic drugs for persistent pain, compared with 34% and 25% in the ketorolac and dezocine groups, respectively. Similarly, less postoperative fentanyl (mean +/- SD) was required in the ketorolac (22 +/- 33 micrograms) and dezocine (18 +/- 35 micrograms) groups, compared with the fentanyl (58 +/- 71 micrograms) group. However, 52% of the patients receiving dezocine required antinausea therapy in the postanesthesia care unit, compared with 20% and 18% in the fentanyl and ketorolac groups, respectively. Finally, recovery times were significantly shorter in the ketorolac (vs dezocine) group. Although both ketorolac and dezocine were effective alternatives to fentanyl when administered during outpatient laparoscopy, dezocine was associated with an increased incidence of postoperative nausea and a delayed discharge time compared with ketorolac.
98 citations
TL;DR: Ketorolac is a beneficial adjuvant to fentanyl PCEA for postoperative pain management after radical retropubic prostatectomy and overall satisfaction in both groups is high, but fewer patients.
Abstract: BACKGROUND: Opioids, although effective postoperative analgesics, are associated with undesirable side effects. In an attempt to determine whether adjuvant, nonopioid medication would permit a reduction of the amount of fentanyl required for postoperative analgesia, the efficacy of ketorolac, an injectable nonsteroidal antiinflammatory drug, was studied as an adjuvant to fentanyl patient-controlled epidural analgesia (PCEA) for postoperative pain management following radical retropublic prostatectomy. METHODS: Forty patients were randomized into two groups to receive fentanyl PCEA and either ketorolac 30 mg intramuscularly every 6 h after an initial dose of 60 mg (n = 20) or placebo (n = 20) for 72 h. Visual analogue scale pain scores (0-100 mm; 0 mm = no pain; 100 mm = worst pain), sedation, fentanyl usage, gastrointestinal function, complications, blood loss, and temperature were assessed four times each day. RESULTS: Visual analogue scale (VAS) pain scores at rest were lower in the ketorolac group during the first 4 h (P < 0.01), but were similar thereafter. Global VAS pain scores with activity were lower in the ketorolac group on postoperative day 1 (23 +/- 4 vs. 39 +/- 6; P < 0.05) and postoperative day 2 (17 +/- 3 vs. 29 +/- 4; P < 0.05). Bladder spasm pain occurred less frequently in the ketorolac group (1 vs. 9 patients; P < 0.05). Fentanyl usage was less in the ketorolac group throughout the study (33 +/- 3 vs. 50 +/- 6 micrograms/h, 0-24 h; 20 +/- 2 vs. 36 +/- 6 micrograms/h, 24-48 h; 12 +/- 2 vs. 24 +/- 6 micrograms/h, 48-72 h; P < 0.05). Sedation scores and side effects were similar, except on postoperative day 3 when nausea was less frequent in the ketorolac group (0 vs. 6 patients; P < 0.05). Recovery of gastrointestinal function occurred sooner in the ketorolac group as determined by first bowel sounds (26 +/- 3 vs. 38 +/- 4 h; P < 0.05), first clear liquids (51 +/- 2 vs. 65 +/- 3 h; P < 0.01), and first regular meal (95 +/- 4 vs. 110 +/- 4 h; P < 0.05). There was no significant difference in blood loss, transfusion requirement, hematocrit, platelet count, or temperature. There was high overall satisfaction in both groups, but fewer patients in the ketorolac group rated pain with walking as usually or always painful (1 vs. 9 patients; P < 0.05). CONCLUSIONS: Ketorolac is a beneficial adjuvant to fentanyl PCEA for postoperative pain management after radical retropubic prostatectomy.
91 citations
TL;DR: Results of this study demonstrate that 0.5% ketorolac ophthalmic solution used topically four times daily, for seven days, was effective in alleviating the principal sign and the symptoms associated with allergic conjunctivitis.
82 citations
TL;DR: Ketorolac, when used in an iv and then oral sequence, is a safe and effective analgesic in the ambulatory surgery setting, which has a slower onset than fentanyl, but causes fewer side effects than C + A.
Abstract: BackgroundGiven he trend toward early discharge of patients after surgery and the inherent adverse effects of opioid analgesics, we compared a new nonsteroidal antiinflammatory drug, ketorolac tromethamine, given intravenously (iv) and then orally, with two commonly prescribed opioid analgesics in a
81 citations
TL;DR: Ketorolac decreased the postoperative requirement for opioid analgesic medication, however, the use of ket orolac failed to decrease postoperative emesis or ventilatory impairment after laparoscopic cholecystectomy.
Abstract: Ketorolac, a nonsteroidal anti-inflammatory drug, is alleged to produce postoperative analgesia without opioid-related side effects. Patients undergoing laparoscopic cholecystectomy were assigned randomly to receive either ketorolac or a placebo (saline) according to a double-blind protocol. Preoperative (baseline) pulmonary function was evaluated using a Respiradyne II monitor. Patients received midazolam, 2 mg, and 2 mL of either ketorolac, 60 mg (n = 31), or saline (n = 29), 20-40 min before surgery. Anesthesia consisted of thiopental, 4-5 mg/kg, and vecuronium, 0.1 mg/kg, for induction, and isoflurane, 0.5%-2.0%, with 67% nitrous oxide in oxygen for maintenance. A second 2-mL dose of the same study medication (ketorolac, 60 mg, or saline) was administered 4 h after the initial dose. Postoperatively, 66% of patients in the saline group complained of pain requiring treatment with fentanyl compared to 32% in the ketorolac group (P < 0.05). There were no significant differences between the two groups with respect to postoperative sedation, anxiety, pain, or nausea visual analog scores. Compared to the preoperative values, significant decreases in pulmonary function tests were noted in both groups at 4 h after the operation and the following morning (P < 0.01). In the ketorolac group, only values of forced expiratory volume at 1 s and forced expiratory flow at 25%-75% of the forced vital capacity at 4 h after the operation were significantly higher than those in the saline group (P < 0.05). Incidences of nausea (45% vs 52%) and vomiting (10% vs 10%) were similar in both groups. In conclusion, ketorolac decreased the postoperative requirement for opioid analgesic medication.(ABSTRACT TRUNCATED AT 250 WORDS)
75 citations
TL;DR: Korolac hastens the return of MMC activity when given postoperatively and completely prevents the delay in intestinal transit and the inhibition of myoelectric activity seen in postoperative ileus when administered preoperatively.
Abstract: The effect of ketorolac, a parenterally administered, nonsteroidal anti-inflammatory drug, was examined in a rat model of postoperative ileus. Small intestinal transit was measured by calculating the geometric center (GC) of distribution of 51 CrO 4 . Laparotomy significantly delayed transit (GC: 2.2 ±0.2 after laparotomy versus 5.6±0.5 for unoperated controls, p
68 citations
TL;DR: In this paper, the effect of ketorolac (Toradol), a potent cyclooxygenase inhibitor used for postoperative pain, on microvascular thrombosis was evaluated.
Abstract: This study was undertaken to evaluate the effect of ketorolac (Toradol), a potent cyclooxygenase inhibitor used for postoperative pain, on microvascular thrombosis in an established thrombosis model. Bilateral 3-mm arterial inversion grafts (n = 66) were constructed in the femoral arteries of New Zealand White rabbits. ALZET (ALZA Corporation, Palo Alto, Calif.) osmotic pumps were implanted in the external jugular veins for drug delivery. The blinded protocol called for the experimental animals to receive intravenous doses of ketorolac of 1.72 mg/kg per day (group 1) or 3.44 mg/kg per day (group 2), while control animals received equivalent volumes of saline. Patency was assessed at 7 days. Whereas 52 percent (13 of 25) of control vessels remained patent, 70 percent (14 of 20) and 86 percent (18 of 21) of group 1 and group 2 vessels, respectively, were patent at 1 week. This decrease in microvascular thrombosis with delivery of ketorolac was statistically significant (p = 0.0094). Ketorolac, at experimental doses approximating 9 and 18 mg IV q6h in a 70-kg man, demonstrated a statistically significant reduction in microvascular thrombosis. This study supports its use in clinical microvascular surgery.
51 citations
TL;DR: It is concluded that ketorolac is important new addition to the available intra-muscular NSAID preparations.
Abstract: A double-blind clinical study was designed to compare the efficacy and safety of intramuscular and oral ketorolac, a new non-steroidal anti-inflammatory analgesic with that of diclofenac and placebo for patients undergoing removal of impacted mandibular third molar teeth. Results showed that both analgesic preparations were more effective than placebo (p=0.0029) and that ketorolac provided a similar degree of pain relief to that of diclofenac. It is concluded that ketorolac is important new addition to the available intra-muscular NSAID preparations.
49 citations
TL;DR: Kentorolac is an effective inhibitor of PRPSA formation and limits small bowel adherence to the pelvis and significantly fewer treated animals had small bowel loops adherent in thepelvis when compared to control animals.
49 citations
TL;DR: Although ketorolac is an effective analgesic, it is a nonsteroidal antiinflammatory agent and thus has the propensity for causing GI ulceration, and caution should be used when administering this drug.
Abstract: OBJECTIVE:To report a case of a perforated gastric ulcer associated with the use of injectable ketorolac tromethamine.DATA SYNTHESIS:A 77-year-old woman with no previous history of peptic ulcer disease developed a perforated gastric ulcer after four days of treatment with ketorolac. To date, six other cases of gastrointestinal (GI) perforation associated with the use of ketorolac have been reported to the manufacturer.CONCLUSIONS:Although ketorolac is an effective analgesic, it is a nonsteroidal antiinflammatory agent and thus has the propensity for causing GI ulceration. Caution should be used when administering this drug and patients should be monitored for GI adverse effects.
Journal Article•
TL;DR: Ketorolac and narcotics in combination provide effective postoperative pain relief and significantly decrease narcotic requirements, which may be particularly beneficial in the subpopulation of patients especially prone to narcotic related complications.
Abstract: Ketorolac tromethamine (Toradol [Syntex, Palo Alto]), a new commercially available nonsteroidal antiinflammatory drug (NSAID), has appropriate solubility and minimal tissue irritation, making it suitable for intramuscular injection. Previously, NSAID have only been available for oral use in the United States for the treatment of pain. Ketorolac, the most potent NSAID known, relieves pain through inhibition of arachidonic acid synthesis at the cyclooxygenase level and has no central opioid effects. The results of previous studies using parenteral ketorolac in combination with patient administered narcotics have shown a 40 percent reduction in narcotic requirements. However, ketorolac is presently only approved for intramuscular injection and oral use in the United States. In a prospective, randomized study, we compared intramuscular ketorolac in combination with patient controlled intravenous narcotic analgesia (morphine) (PCA-M) to PCA-M alone for the control of pain after extensive colonic resections. The combination of intramuscular ketorolac and PCA-M provided equal pain relief with no increased side effects when compared with narcotics alone. However, narcotic requirements of the patients were decreased by an average of 45 percent. Ketorolac and narcotics in combination provide effective postoperative pain relief and significantly decrease narcotic requirements. This combination may be particularly beneficial in the subpopulation of patients especially prone to narcotic related complications.
TL;DR: Three patients who were treated with ketorolac tromethamine (Toradol), an injectable nonsteroidal anti-inflammatory drug for pain management, developed acute renal failure or hyperkalemia or both and were reversible in two cases after discontinuing the drug.
Abstract: Three patients who were treated with ketorolac tromethamine (Toradol), an injectable nonsteroidal anti-inflammatory drug for pain management, developed acute renal failure or hyperkalemia or both. These complications were reversible in two cases after discontinuing the drug. Clinical conditions preexisted in each patient that rendered them susceptible to the renal complications of nonsteroidal anti-inflammatory use. It is well known that caution should be observed while using nonsteroidal anti-inflammatory drugs in patients whose renal function may be preserved through prostaglandin-mediated vasodilatory effects. The same cautions apply to ketorolac. Since its major marketed use is as an analgesic and its potent effect on prostaglandin synthesis may not be well recognized, those cautions must be emphasized. (Arch Intern Med. 1993;153:1000-1002)
TL;DR: The purpose of this study was to determine the efficacy of a ketorolac tromethamine used for the management of the postoperative pain produced as a result of outpatient ACL reconstruction.
Abstract: Summary Pain control is an important postoperative consideration with any surgical procedure. Technological and procedural improvements have contributed to the reduction in both the degree of surgical difficulty and the postsurgical complications associated with intricate surgeries. As a result, certain surgeries have potential for being performed on an outpatient basis, dependent upon appropriate pain-management regimens and the degree of potential for postoperative complications. Arthroscopic anterior cruciate ligament (ACL) reconstruction is a common procedure. Because of the reduction in invasiveness that arthroscopy provides, outpatient surgery is now routinely employed for ACL patients. The arguments against ACL outpatient surgery have included the reluctance to use ambulatory, indwelling, intravenous pain-pump delivery systems for opioid pain medication. The purpose of this study was to determine the efficacy of a ketorolac tromethamine used for the management of the postoperative pain produced as a result of outpatient ACL reconstruction. When the ketorolac pain management regimen is compared in this setting with meperidine or morphine, pain control is as good as, or in some cases better than, either of the opioid drugs. Additionally, the adverse side effects associated with opioid drugs are significantly reduced at a substantially lower direct cost to the patient.
TL;DR: Although there were no significant differences in intraoperative mean arterial pressure, heart rate, and oxygen saturation of hemoglobin values among the three treatment groups, the ketorolac group manifested significantly more rapid respiratory rates throughout the procedure compared with the fentanyl and combination groups.
Abstract: In healthy outpatients undergoing minor gynecologic surgery, the analgesic efficacy of ketorolac was compared to fentanyl and to a combination of the two analgesics. One hundred and nine patients were randomly selected to receive fentanyl 50-100 micrograms, ketorolac 30-60 mg, or a combination of fentanyl 50-100 micrograms and ketorolac 30-60 mg, intravenously (IV). Anesthesia was induced with midazolam 2 mg IV and propofol 1 mg/kg, IV, and maintained with propofol, 50-160 micrograms.kg-1.min-1, IV, and nitrous oxide 67% in oxygen via a face mask. Intraoperative anesthetic conditions, recovery times, and postoperative pain and side effects were evaluated. In the ketorolac group, 75% of patients required supplemental fentanyl intraoperatively (mean dose +/- SD, 47 +/- 54 micrograms), compared to only 19% (13 +/- 30 micrograms) and 18% (6 +/- 15 micrograms) of patients in the fentanyl and combination groups, respectively. In the ketorolac group, 74% of patients moved in response to surgical stimulation compared to only 16% and 19% of patients in the fentanyl and combination groups, respectively. Although there were no significant differences in intraoperative mean arterial pressure, heart rate, and oxygen saturation of hemoglobin values among the three treatment groups, the ketorolac group manifested significantly more rapid respiratory rates throughout the procedure compared with the fentanyl and combination groups. Recovery times, postoperative side effects, and pain scores, as well as postoperative analgesic and antiemetic requirements, were similar in all three treatment groups. However, the ketorolac group reported significantly higher pain scores in the early postoperative period.(ABSTRACT TRUNCATED AT 250 WORDS)
TL;DR: Since ketorolac is excreted almost entirely by the kidney, either elderly patients or patients with underlying renal insufficiency must have an adjustment of the dosing interval, or this medication should be avoided in such patients altogether.
Abstract: The success of ketorolac as a nonnarcotic analgesic is likely to propagate its widespread use to control moderate to severe postoperative pain. Indeed, of the patients treated with ketorolac and described in the medical literature, nearly 90% had had a major surgical procedure. Since any such procedure may be associated with significant third-spacing of the fluid and result in renal hypoperfusion, care must be taken in administering ketorolac. Close attention to urine output and parameters of renal function must be maintained. Moreover, postoperative ketorolac therapy should be avoided in patients who have conditions that predispose to NSAID nephrotoxicity (as in our Case 1). Likewise, in nonsurgical patients the same degree of caution should be used with ketorolac as with any oral NSAID. Finally, since ketorolac is excreted almost entirely by the kidney, either elderly patients or patients with underlying renal insufficiency must have an adjustment of the dosing interval, or this medication should be avoided in such patients altogether.
TL;DR: It can be concluded that intravenous ketorolac is an effective analgesic agent for the control of pain in patients with renal colic.
Abstract: The objective of this study was to report the authors' experience using intravenous ketorolac (Syntex Laboratories, Palo Alto, CA) as an analgesic in the treatment of renal colic in a convenience sample at three suburban community hospital emergency departments. Twenty-five patients with renal colic were participants. Pregnant women, patients with a history of renal or hepatic impairment, bleeding diathesis, active peptic ulcer disease, or hypersensitivity to aspirin or nonsteroidal antiinflammatory drugs (NSAID) were excluded. Ketorolac 30 mg administered intravenously during a 1-minute period, and the following parameters were monitored at times 0, 5, 10, 20, 30, and 60 minutes: pain on a scale of 0 to 10, pulse rate, blood pressure, and adverse side effects. A total of 25 patients were included in our series. Initially, they had a median pain score of 9 with an interquartile range of 1. Thereafter, the median pain scores and (interquartile ranges) were 8 (three) at 5 minutes, 5 (four) at 10 minutes, 2 (four) at 20 minutes, 1 (three) at 30 minutes, and 0 (one) at 60 minutes. There were no adverse side effects observed in any patients. Therefore, it can be concluded that intravenous ketorolac is an effective analgesic agent for the control of pain in patients with renal colic.
TL;DR: Although the sensitivity of central prostaglandin synthetase systems to inhibition is unknown, it is unlikely from this pharmacokinetic data that there is a major central mechanism of analgesia for ketorolac.
TL;DR: All patients with pain due to advanced malignant disease became symptom-free with the introduction of ketorolac by subcutaneous infusion and the total daily opioid requirement was substantially reduced in three and reduced to zero in four patients.
Abstract: Pain due to advanced malignant disease does not always respond to opioids, or the possible use of opioids may be limited by the occurrence of adverse effects. This paper describes the successful use of ketorolac, a new nonsteroidal anti-inflammatory drug, given by continuous subcutaneous infusion. Seven patients with pain due to advanced malignant disease taking opioid analgesia were considered to have inadequate symptom control because of opioid unresponsiveness (n = 1), opioid-related adverse effects (n = 2) or both (n = 4). All patients became symptom-free with the introduction of ketorolac by subcutaneous infusion and the total daily opioid requirement was substantially reduced in three and reduced to zero in four patients.
TL;DR: Nausea and vomiting were common in all four groups, especially in patients treated with metamizole, but the need for antiemetics was significantly lower with tramadol and lysine clonixinate.
Abstract: We compared the analgesic efficacy and safety of tramadol, a new pure agonistic central analgesic, with that of three nonsteroidal anti-inflammatory drugs (NSAIDs) in the control of postoperative pain. A total of 160 patients undergoing abdominal hysterectomy participated in this randomized, double-blind study. Four treatment groups were established: tramadol, metamizole, ketorolac, and lysine clonixinate, with 40 patients in each group. Analgesics were administered using continuous infusion plus patient-controlled analgesia. During this 24-hour study, pain was assessed by using a visual analog scale. The number of boluses required per patient, the number of patients requiring supplementary analgesia, the presence of nausea or vomiting, the need for antiemetics, and an evaluation of overall efficacy also were recorded during the first 24 hours after surgery. The analgesic efficacy of tramadol was found to be greater than that of the three NSAIDs. Tramadol also was statistically significantly better than the other three agents with regard to the number of boluses required per patient (1.6 versus 4.4 for metamizole, 4.5 for ketorolac, and 5.3 for lysine clonixinate) and the number of patients requiring supplementary analgesia (1 patient versus 5 for metamizole, 11 for ketorolac, and 11 for lysine clonixinate). Nausea and vomiting were common in all four groups, especially in patients treated with metamizole, but the need for antiemetics was significantly lower with tramadol and lysine clonixinate. With regard to overall efficacy, as rated by the physician, excellent and very good results were obtained in 79.5% of the patients in the tramadol group, compared with 57.5%, 57.5%, and 50% of those in the metamizole, ketorolac, and lysine clonixinate groups, respectively (P
TL;DR: It is suggested that neuraxial placement of ketorolac may prove useful in the clinical setting for the management of acute pain in humans and Activation of nor-binaltorphimine-sensitive receptors appears to be an integral element in the mechanism of antinociception of ket orolac at the spinal level.
TL;DR: Indiscriminate use of ketorolac for pain management in place of narcotic analgesics should be avoided, especially in patients at high risk for toxicity induced by nonsteroidal antiinflammatory drugs, due to reports of renal toxicity associated with intramuscular ket orolac tromethamine.
Abstract: OBJECTIVE:To evaluate reports of renal toxicity associated with intramuscular ketorolac tromethamine. Medical charts were reviewed for all cases of renal toxicity associated with ketorolac therapy.METHODS:Patients with possible ketorolac-associated nephrotoxicity were identified through our institution's adverse drug reaction reporting program. Patients were included in this report if: (1) renal insufficiency was temporally related to ketorolac administration; (2) resolution of renal insufficiency occurred after discontinuation of ketorolac; and (3) no other causes of renal insufficiency, including other medications, could be identified.RESULTS:Six patients had renal insufficiency secondary to ketorolac administration. The mean age of the patients was 58 years and cardiovascular disease was present in five. Serum creatinine values increased from a mean of 106 ± 26 μmol/L (1.2 ± 0.3 mg/dL) to a mean peak value of 256 ± 195 μmol/L (2.9 ± 2.2 mg/dL). Recovery of renal function was observed after a mean of 2....
TL;DR: Ketorolac 30 mg and pethidine 75 mg provided similar but variable quality of analgesia after caesarean section under general anaesthesia, and overall assessment of analgesIA was similar between groups, although more side-effects (nausea, dizziness) were noted in the pETHidine group.
Abstract: We compared, in a double-blind randomised study, intramuscular ketorolac 30 mg (n = 49) and intramuscular pethidine 75 mg (n = 51) for analgesia after elective caesarean section under general anaesthesia. Anaesthesia was induced with thiopentone and suxamethonium and maintained with atracurium, nitrous oxide and isoflurane. Intravenous fentanyl 100 micrograms was given after delivery of the neonate. In the recovery ward, patients who requested analgesia were allocated randomly to receive ketorolac 30 mg or pethidine 75 mg intramuscularly. Analgesia was assessed at intervals up to six hours, using a visual analogue scale and a four-point verbal scale, while duration of analgesia was taken as the time until the patient requested additional analgesia. There was no difference in the duration of analgesia between groups (Mann-Whitney test P = 0.27, Mantel-Haentszel test P = 0.17). Twenty-six patients in the ketorolac group and 17 patients in the pethidine group requested further analgesia by 90 minutes. However, four patients in the ketorolac group and six patients in the pethidine group requested no further analgesia within 24 hours. Pain VAS and overall assessment of analgesia was similar between groups, although more side-effects (nausea, dizziness) were noted in the pethidine group. Ketorolac 30 mg and pethidine 75 mg provided similar but variable quality of analgesia after caesarean section.
TL;DR: It is concluded that im ketorolac and pr indomethacin are equally effective analgesics in this group of patients and side effects were similar in all groups.
Abstract: Injectable ketorolac is an effective analgesic in ambulatory surgery patients. However, no studies have compared ketorolac with other NSAIDs in this setting. The analgesic efficacy of intramuscular ketorolac, rectal indomethacin and placebo was compared in healthy women undergoing gynaecological or breast surgery as outpatients. Ninety patients received 30 mg im ketorolac, 100 mg pr indomethacin or placebo in a prospective, randomized, double-blind manner. A standardized anaesthetic protocol was followed. Patients graded their pain on a 10 cm visual analogue scale in the recovery room, twice in the surgical day care unit and during the car ride home. The patients' postoperative fentanyl requirements, time to recovery milestones, and side effects were recorded. The placebo group received more fentanyl in the PACU but did not achieve the same pain relief as either of the NSAID-treated group (ketorolac 44 +/- 53 micrograms, indomethacin 39 +/- 55 micrograms, placebo 87 +/- 100 micrograms, P < 0.05). Patients who received an NSAID had less pain at 15 and 90 min (P < 0.05). The PACU stay was longer for the placebo group (ketorolac 50 +/- 13 min, indomethacin 49 +/- 12 min, placebo 62 +/- 35 min, P < 0.05). Time to ambulation was also longer in the placebo group (ketorolac 117 +/- 25 min, indomethacin 121 +/- 49 min, placebo 140 +/- 51 min, P < 0.05). However, no differences were observed between the two NSAIDS. Side effects were similar in all groups. We conclude that im ketorolac and pr indomethacin are equally effective analgesics in this group of patients.
TL;DR: Patients who presented in the emergency department during the period between April and July 1992 with a previous diagnosis of migraine headache were considered for the study and subjectively evaluated parameters of their migraine headaches with a numerical scale.
Abstract: The objective of this study was to determine the speed and efficiency of ketorolac in reducing the symptoms of migraine headache. Twenty-three patients who presented in the emergency department during the period between April and July 1992 with a previous diagnosis of migraine headache were considered for the study. Patients subjectively evaluated parameters of their migraine headaches (eg, pain and nausea) with a numerical scale and were asked to re-evaluate these same parameters at 30, 60, and 360 minutes after a single injection of Ketorolac. Seventeen (74%) patients reported a decrease in headache symptoms that was significant (P < .005) after 1 hour. Relief lasted at least 6 hours after injection.
TL;DR: The HPLC method is suitable for the analysis of large numbers of plasma samples and has been applied in this report to a pharmacokinetic study of ketorolac enantiomers upon intramuscular administration of racemic drug to a human subject.
Patent•
08 Sep 1993TL;DR: The optically pure R-ketorolac is also useful in treating pyrexia while avoiding the adverse effects associated with the administration of the racemic mixture of ketorolacs as mentioned in this paper.
Abstract: Methods are disclosed utilizing optically pure R-ketorolac for the treatment of pain, including but not limited to pain associated with toothaches, headaches, sprains, joint pain and surgical pain, for example dental pain (e.g., after periodontal surgery) and ophthalmic pain (e.g., after cataract surgery) while avoiding adverse effects which are associated with the administration of the racemic mixture of ketorolac. The optically pure R-ketorolac is also useful in treating pyrexia while avoiding the adverse effects associated with the administration of the racemic mixture of ketorolac.