title: Opioid analgesics versus ketorolac in spine and joint procedures: impact on healthcare resources.
abstract: BACKGROUND
  Ketorolac's efficacy as a postoperative analgesic has been shown to be comparable to that of narcotic analgesics, but with significantly fewer narcotic-related adverse events.
  
  
  OBJECTIVE
  To assess whether the choice of postoperative analgesic, narcotic or ketorolac, has an impact on healthcare resource utilization and cost durng inpatients' recovery period.
  
  
  METHODS
  Retrospective, multicenter, controlled, parallel, cost-minimization analysis.
  
  
  METHODS
  Six US teaching hospitals.
  
  
  METHODS
  This study included 559 patients that underwent either a spine or joint procedure and received adequate doses of narcotic (n = 284 of either morphine or meperidine) or ketorolac (n = 275).
  
  
  METHODS
  Time to reach recovery milestones, average utilization of healthcare resources, and average per-case postoperative treatment cost.
  
  
  RESULTS
  Several recovery milestones, including time to first bowel movement, first oral intake, and first unassisted ambulation, were reached sooner in the ketorolac group, with a resultant shorter mean length of postoperative stay (narcotic 3.78 d, ketorolac 2.80 d; p = 0.01). Total per-patient cost of treatment was 32% greater in the narcotic group, resulting primarily from higher costs associated with hospitalization.
  
  
  CONCLUSIONS
  Despite the higher acquisition cost of medication, healthcare resource utilization and total per-patient cost of treatment were lower for patients in the ketorolac group compared with patients in the narcotic analgesic study group. The majority of patients in the ketorolac group were also given concurrent narcotic analgesics; therefore, the beneficial effects observed may be secondary to the combination of ketorolac and narcotic analgesics.
authors.affiliation: Drug Information Center, College of Pharmacy and Hospital, University of Kentucky, Lexington, USA. mharp1@pop.uky.edu
authors.forename: M L
authors.initials: ML
authors.lastname: Gora-Harper
authors.forename: K E
authors.initials: KE
authors.lastname: Record
authors.forename: T
authors.initials: T
authors.lastname: Darkow
authors.forename: P A
authors.initials: PA
authors.lastname: Tibbs
mesh_terms: D000701:Analgesics, Opioid / Q000191:economics / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics / Q000627:therapeutic use*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007596:Joints / Q000601:surgery*; D020910:Ketorolac / Q000191:economics / Q000627:therapeutic use*; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000188:drug therapy* / Q000191:economics; D012189:Retrospective Studies; D013131:Spine / Q000601:surgery*
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D020910:Ketorolac