Continuous intravenous administration of ketorolac reduces pain and morphine consumption after total hip or knee arthroplasty.
The purpose of this study was to determine the analgesic efficacy, opioid-sparing effect, and tolerability of ketorolac administered as an intravenous (i.v.) bolus followed by a continuous infusion after total hip or knee arthroplasty. After general anesthesia, patients received either placebo or ketorolac 30 mg i.v. as a bolus over 15-30 s followed by a continuous i.v. infusion of ketorolac 5 mg/h for 24 h. All patients received patient-controlled i.v. morphine with no background infusion. Patients were assessed at 2, 4, 6, and 24 postoperatively with respect to analgesia, morphine consumption, side effects, and blood loss. Patients receiving ketorolac reported were less sedated and required fewer antiemetics. There was no difference in blood loss. Patients receiving ketorolac reported better analgesia and used less morphine (35% for hips and 44% for knees) than those receiving placebo.
D000368:Aged; D000698:Analgesia; D016058:Analgesia, Patient-Controlled; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage* / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use; D003243:Consciousness / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D020910:Ketorolac; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010919:Placebos; D019106:Postoperative Hemorrhage; D011446:Prospective Studies; D014046:Tolmetin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000932:Antiemetics; D006993:Hypnotics and Sedatives; D010919:Placebos; D009020:Morphine; D014046:Tolmetin; D020910:Ketorolac