title: Subcutaneous ketorolac--a new development in pain control.
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.
authors.affiliation: Mount Vernon Hospital, Northwood, Middlesex, UK.
authors.forename: N
authors.initials: N
authors.lastname: Blackwell
authors.forename: L
authors.initials: L
authors.lastname: Bangham
authors.forename: M
authors.initials: M
authors.lastname: Hughes
authors.forename: D
authors.initials: D
authors.lastname: Melzack
authors.forename: I
authors.initials: I
authors.lastname: Trotman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D020910:Ketorolac; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use*; D009369:Neoplasms / Q000503:physiopathology*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D014046:Tolmetin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D009294:Narcotics; D014046:Tolmetin; D020910:Ketorolac