title: Economic assessment of ketorolac versus narcotic analgesics in postoperative pain management.
abstract: The medical records for 174 patients who underwent cholecystectomy (n = 52) or hip/knee replacement (n = 122) at four community-based medical centers were retrospectively reviewed to determine if using a nonnarcotic alternative to morphine sulfate and/or meperidine as a primary postoperative analgesic could reduce resource costs per patient. Two cohorts were constructed: 87 patients received either morphine sulfate or meperidine as the primary postoperative analgesic, and 87 patients received ketorolac. Ketorolac patients undergoing cholecystectomy were associated with lower per case costs in inpatient care (length of stay), direct nursing labor, PRN (as required) procedures, and medications relating to emesis and to gastrointestinal distress. Higher per case costs were recorded for the primary analgesic (study drug) and for supplemental pain medications. In contrast to substantial differences in the acquisition cost of ketorolac versus morphine sulfate/meperidine, the ketorolac cholecystectomy group was associated with lower overall resource costs per patient. In joint replacement procedures, however, the ketorolac group was associated with higher overall resource costs per patient, attributable primarily to a slightly higher postoperative length of stay.
authors.affiliation: Ovation Healthcare Research, Inc., Highland Park, Illinois.
authors.forename: J P
authors.initials: JP
authors.lastname: Trotter
authors.forename: S P
authors.initials: SP
authors.lastname: Reinhart
authors.forename: R M
authors.initials: RM
authors.lastname: Katz
authors.forename: H S
authors.initials: HS
authors.lastname: Glazier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000191:economics* / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics* / Q000627:therapeutic use; D002763:Cholecystectomy; D006295:Health Resources / Q000191:economics*; D006622:Hip Prosthesis; D006801:Humans; D020910:Ketorolac; D007720:Knee Prosthesis; D008614:Meperidine / Q000627:therapeutic use*; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D014046:Tolmetin / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009020:Morphine; D008614:Meperidine; D014046:Tolmetin; D020910:Ketorolac