title: Ketorolac versus meperidine for pain relief after orthopaedic surgery.
abstract: In this double-blind, randomized, multicenter study, 244 patients with at least moderate pain after major orthopaedic surgery received intramuscular Ketorolac (60 mg followed by 30 mg) or intramuscular meperidine (100 mg or placebo) every 2 to 6 hours as needed for as many as 5 days. Analgesic response was evaluated for 6 hours after initial study drug administration and thereafter each night at bedtime. Both active treatment groups had similar 3-hour summed pain intensity difference and 3-hour total pain relief scores after the first dose that were superior to placebo. The 6-hour summed pain intensity difference and total pain relief scores were significantly higher with Ketorolac than with meperidine or placebo. The mean daily categorical pain intensity scores were comparable with Ketorolac and meperidine, and both were significantly superior to placebo. Patient ratings of overall medication efficacy were significantly better with Ketorolac than with meperidine. In both patient and observer evaluations, Ketorolac was significantly better tolerated than meperidine, and the number of patients reporting adverse events was lower with Ketorolac than with meperidine. Following major orthopaedic surgery, Ketorolac provided effective analgesia that was superior to placebo and at least comparable with meperidine. Ketorolac was better tolerated than meperidine.
authors.affiliation: Department of Orthopaedic Surgery, Emory University Clinic, Atlanta, GA, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: DeAndrade
authors.forename: M
authors.initials: M
authors.lastname: Maslanka
authors.forename: H D
authors.initials: HD
authors.lastname: Reines
authors.forename: D
authors.initials: D
authors.lastname: Howe
authors.forename: G L
authors.initials: GL
authors.lastname: Rasmussen
authors.forename: J
authors.initials: J
authors.lastname: Cardea
authors.forename: J
authors.initials: J
authors.lastname: Brown
authors.forename: L
authors.initials: L
authors.lastname: Bynum
authors.forename: A
authors.initials: A
authors.lastname: Shefrin
authors.forename: Y L
authors.initials: YL
authors.lastname: Chang
authors.forename: T
authors.initials: T
authors.lastname: Maneatis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects*; D020910:Ketorolac; D008297:Male; D008614:Meperidine / Q000627:therapeutic use*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014046:Tolmetin / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D008614:Meperidine; D014046:Tolmetin; D020910:Ketorolac