PEARLS FROM THE TORRES STRAIT AND NORTHERN PENINSULA AREA
What dose Ketorolac?
Posted On July 2, 2017
Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial Motov, Sergey et al. Annals of Emergency Medicine 2016 Dec.
N = 240, 18-65 years
Randomised to receive 10mg, 15mg, 30mg IV ketorolac as single dose (double blinded)
Acute flank, abdominal, MSK or headache pain with intensity > 5/10
Pain scores, vital signs, adverse effects recorded at baseline, 15, 30, 60, 90, 120 minutes
Subjects still desiring pain medication 30mins after study drug administration were offered IV morphine 0.1mg/kg as a rescue
Age > 65
Pregnancy or breastfeeding
Active peptic ulcer disease
Acute GI haemorrhage
Known renal or hepatic insufficiency
Allergy to NSAIDs
Unstable vital signs
Patients that had already received an analgesic
There was no difference in reduction of pain scores between the groups
–10 mg – 7.7 to 5.2
–15 mg – 7.5 to 5.1
–30 mg – 7.8 to 4.8
No different in the use of rescue morphine
No clinically concerning change in vital signs and no clinically significant adverse effects related to the study medication at any dose
No placebo group
Ketorolac has similar analgesic efficacy at IV doses of 10, 15 and 30mg
The ceiling dose of 10mg provides effective pain relief to ED patients with moderate to severe pain without increased adverse effects
BSc, MBBS(Hons), FRACGP, FARGP.
Background in the Australian Defence Force RAAMC, Royal Flying Doctor Service and Emergency Medicine. Robin enjoys medical education, systems of primary health care delivery and op-shopping.