NSAID use and efficacy in the emergency department: single doses of oral ibuprofen versus intramuscular ketorolac.
OBJECTIVE
To compare the clinical efficacy of single doses of intramuscular ketorolac and oral ibuprofen in the emergency department (ED) treatment of acute pain.


METHODS
A retrospective analysis of data collected during a prospective survey of pain management efficacy. The design was noninterventional, and therapy was selected by the treating physician independent of the trial.


METHODS
Urban teaching hospital adult patient emergency department.


METHODS
A convenience sample of ED patients in acute pain.


METHODS
Patients received ibuprofen 800 mg po (n = 95), or ketorolac 60 mg im (n = 30) as a single dose. Therapy was selected by the treating physician and was not influenced by the study.


RESULTS
Data collected were a 100-mm visual analog pain scale at patient arrival and discharge, verbal description of pain relief, patient demographics, pain management data, and discharge diagnosis. Baseline pain intensity was higher in patients receiving ketorolac (77 mm median) than in those receiving ibuprofen (65 mm, p = 0.02). Pain relief was similar (p = 0.29) with either treatment when assessed by visual analog scale or patient definition of pain relief.


CONCLUSIONS
A single dose of either nonsteroidal antiinflammatory drug produced similar pain relief in the general ED population during clinical treatment of pain. Ketorolac should not necessarily be considered a more effective analgesic than ibuprofen in these commonly used doses.
Wright
J M
JM
Department of Medicine, School of Medicine, University of Missouri-Kansas City.
Price
S D
SD
Watson
W A
WA
D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004636:Emergency Service, Hospital; D005260:Female; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D007273:Injections, Intramuscular; D020910:Ketorolac; D008297:Male; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D012189:Retrospective Studies; D014046:Tolmetin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D014046:Tolmetin; D007052:Ibuprofen; D020910:Ketorolac