• The Korean Journal of Pain
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• 제8권1호
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• pp.43-50
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• 1995

The purpose of this study was to compare postoperative analgesic effect according to intravenous doses of ketorolac. The ninety-eight adult patients, scheduled for elective surgery under general anesthesia, were randomly assigned to receive saline or one of the five doses of ketorolac (10, 15, 30, 45, 60mg). After recoverg from anesthesia, saline or ketorolac was injected intravenously, and the visual analogue score, sedation secore, mean blood pressure, heart rate, and the incidence of nausea and vomiting were measured 30 minutes, 1 hour and 2 hours the injection. Saline or 10 mg of ketorolac had no postanalgesic effect. Above 15 mg of ketorolac had analgesic effect, but this analgesic effect was not increased with increasing doses of ketorolac (30, 45, 60 mg). Any side effects (nausea, vomiting, excessive sedation, cardiopulmonary depression, and renal and hematologic adverse events) was not observed associated with ketorolac administration. These results suggested that 15 mg of ketorolac is the most reliable dose for postoperative anlgesia in intravenous administration.

• The Korean Journal of Pain
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• 제13권2호
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• pp.213-217
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• 2000

Background: This study was conducted to evaluate and compare the effectiveness of intravenous ketorolac and wound infiltration in producing postherniorrhaphy analgesia in pediatric surgery. Methods: Forty consenting healthy children, aged 3~7 yr, were randomly assigned to receive intravenous ketorolac (1 mg/kg) or wound infiltration (0.25% bupivacaine 0.3 ml/kg) before closure of the surgical wound after inguinal herniorrhaphy. Pain was evaluated by using an observer pain score at 30 min, 60 min and 4 hrs intervals, postoperatively. Results: It is statistically significant that the wound infiltration group had lesser pain than the ketorolac group at 30 min and 60 min. But there is no difference between the groups at 4 hrs, postoperatively. Conclusions: We concluded that wound infiltration may provide better analgesia compared to intravenous ketorolac for up to 4 hours postoperative for treatment of pain after inguinal herniorrhaphy in pediatric surgery.

• The Korean Journal of Pain
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• 제12권1호
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• pp.54-58
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• 1999

Background: We studied 150 patients who received intravenous patient controlled analgesia (PCA) after total abdominal hysterectomy to evaluate pain relief, analgesic consumption, patient's satisfaction and side effects. Methods: We made total 40 ml of analgesic mixture with morphine 40 mg, ketorolac 120 mg, droperidol 3 mg and normal saline. Loading/bolus/basal infusion dose and lockout interval was 2 ml, 1.5 ml, 0.5 ml/hr and 10 min, respectively. Numerical rating scale (NRS) pain score, cumulative analgesic consumption, degree of satisfaction, and incidence of side effects were evaluated. Also, correlation of age and edu ion with analgesic consumption were evaluated. Results: The average pain scores using NRS were $3.1{\pm}1.7$ (6 h), $2.1{\pm}1.5$ (24 h), $1.7{\pm}1.5$ (48 h). The average cumulative analgesic consumption were $11.7{\pm}5.0$ ml (6 h), $23.0{\pm}6.7$ ml (24 h), $32.1{\pm}3.7$ ml (48 h). The degree of satisfaction in postoperative pain control was good in 94% of patients. There was no correlation between degree of satisfaction and analgesic consumption. Also age and level of edu ion did not correlated with analgesic consumption. Conclusions: Intravenous PCA with morphine, ketorolac, and droperidol is an effective method of postoperative pain control because it provides adequate pain relief and a few side effects with high patient's satisfaction. However, age and level of education did not correlated with analgesic consumption.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.449-454
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• 2012

Purpose: Intravenous sedation with midazolam is common in contemporary dentistry. That is effective for anxious patients, but additional analgesic agent needs to be used, because midazolam alone doesn't have an analgesic effect. This study was performed to select an analgesic agent between an opioid agent, and nonsteroidal anti-inflammatory drugs as adjunctives in intravenous sedation with midazolam. Methods: The subjects were 60 patients who visited the Department of Oral and Maxillofacial Surgery, Sacred Heart Hospital, Hallym University, between August 2009 and February 2010. Conscious sedation was performed on 20 patients of 3 groups (control group, ketorolac group, and fentanyl group), who were divided randomly. The analgesic agent was administrated preoperatively. For sedation, vital signs were recorded. After sedation and operation, subjective questionnaires of the patient and operator were implemented. Results: All of the $SPO_2$, blood pressure, and heart rates stayed within the normal range for sedation. The sedation depth and analgesic effect of the ketorolac group and fentanyl group were similar. In the case of sedation depth, 12 patients in the ketorolac group and 14 patients in the fentanyl group had no memory of surgery. In the case of analgesic effect, the visual analogue scale of pain scored 2~3 in 13 patients in the ketorolac group, and 0~2 in 12 patients in the fentanyl group. The satisfaction of patients and doctors was also similar. Conclusion: Considering the management and complication of an opioid agent, non-steroidal anti-inflammatory drugs is more effective than an opioid agent.

• Journal of Dental Anesthesia and Pain Medicine
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• 제21권1호
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• pp.1-14
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• 2021

This study aimed to evaluate and compare the pre-emptive analgesic efficacy of injected ketorolac to that of other agents for impacted third molar surgical removal in a healthy population. PubMed, Ovid SP, Cochrane databases were filtered from 1980 to July 2020 for potential papers using relevant MeSH terms and pre-specified inclusion and exclusion criteria independently by reviewers. Studies that compared pre-emptive intramuscular or intravenous administration of ketorolac to other agents were evaluated. The outcomes sought were self-reported postoperative pain (patient-perceived pain), median duration for rescue analgesic medication, total number of analgesics consumed in the recovery period, and global assessment (overall patient satisfaction) after the recovery period. Six studies were included in the final evaluation. The outcome of pain perception and the number of analgesics taken were significantly lower in the ketorolac group (intramuscular or intravenous) in most of the studies (n=5) than in the group of other drugs. The mean time for rescue analgesia intake was higher for the ketorolac group, and global assessment scores were also better in the ketorolac group. Although the included studies show significantly better outcomes such as postoperative pain, median time taken for rescue medication, total number of analgesics taken, and overall patient satisfaction with injected ketorolac group in comparison to injected diclofenac, dexamethasone, and tramadol, definitive conclusions cannot be made regarding the superiority of injected Ketorolac as a pre-emptive agent. A greater number of randomized control trials with a proper protocol are needed to make definitive conclusions.

• The Korean Journal of Pain
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• 제13권1호
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• pp.38-43
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• 2000

Background: Preemptive analgesia may decrease postoperative pain by preventing nociceptive inputs generated during surgery. The preemptive effect of intravenous nalbuphine was examined in gynecological surgery. Methods: Forty female patients scheduled for gynecological surgery were randomly allocated into two groups. Each patient received 10 mg of intravenous nalbuphine as a bolus dose at the closure of peritoneum in group I (n=20) and before the skin incision in group II (n=20). After the bolus dose, the intravenous patient controlled analgesia (IV-PCA) which contained 50 mg of nalbuphine, 120 mg of ketorolac, 0.25 mg of droperidol and 90 ml of 5% dextrose water was given continuously at the rate of 2 ml/min. The postoperative visual analogue scale pain score (VAS), the total amount of the analgesics used, the degree of satisfaction of the patients and the developement of side effects were examined for 2 days. Results: VAS were significantly lower in group II than in group I after 9 and 12 hours. The cumulative consumption of analgesics in group II was significantly less than in group I. Most patients were satisfied with this regimen. There were no remarkable side effects. Conclusions: Preemptive analgesia with intravenous nalbuphine decreased postoperative pain and analgesic requirement. The analgesic effect of IV-PCA with nalbuphine-ketorolac was effective in control of postoperative pain in gynecologic surgery.

• The Korean Journal of Pain
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• 제10권2호
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• pp.179-184
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• 1997

Background: Ketorolac($Tarasyn^{(R)}$) is a non-steroidal anti-inflammatory drug(NSAID) which has shown to be an effective postoperative analgesic available parenterally, and when combined with morphine can reduce its requirement. The analgesic efficacy and adverse effects of continuous infusion of ketorolac added to morphine IV PCA was evaluated in 60 women after abdominal hysterectomy. Methods: Patients were assigned to receive either morphine intravenous(IV) bolus followed by morphine IV patient controlled analgesia(PCA), or ketorolac 30mg IV and continuous IV infusion at 4.0mg/hr in combination with the above regimen. The authors evaluated PCA morphine used, pain assessment(verbal pain intensity score and visual analogue scale) and side effects at 2, 4, 6 and 24hrs during pain control. Results: Continuous infusion of ketorolac decreased the PCA morphine usage significantly(30.4 ---> 19.6 mg : p=0.007) at 24hrs postoperatively. Significant differences were seen favoring ketorolac infusion in pain intensity and visual analogue scale both at rest and during movement. There were no differences in incidences of deep sedation, nausea & vomiting. But the ketorolac group they complained of dizziness more than morphine only group. Little pruritus was recorded in either groups. Conclusions: The authors conclude continuous IV infusion of ketorolac in conjunction with morphine PCA provide effective analgesia after low abdominal surgery.

• 한국임상약학회지
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• 제28권4호
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• pp.279-284
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• 2018

Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for post-operative pain management in general surgery patients in South Korea.

• The Korean Journal of Pain
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• 제6권1호
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• pp.32-39
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• 1993

전북대학교 병원에 입원하여 하복부 수술을 받는 미국 마취과학회 전신상태 분류상 class I, II인 환자 40명을 대상으로 수술후 morphine(1군)과 ketorolac(2군)을 지속적으로 정주한 결과 다음과 같은 결론을 얻었다. 1) 1군과 2군 모두 수술후 통증에 의의 있는 감소를 보였으며 군 간의 차이는 없었다. 2) 1군에서 2군보다 부작용의 빈도가 많았다. 이상의 결과로 수술후 통증 관리에 있어서 morphine과 ketorolac의 지속적 정맥 주입 방법은 모두 효과적이었으며, ketorolac이 morphine보다 부작용의 발현 빈도가 더 적은것으로 보아 morphine을 대신할 수 있는 유용한 약물로 사료된다.

• The Korean Journal of Pain
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• 제7권1호
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• pp.78-83
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• 1994

수술후 통증치료에 morphine과 buprenorphine의 효과를 알아보기 위하여 morphine과 buprenorphinec을 단독 투여하거나(1, 2군) buprenorphine과 ketorolac을 반량씩 혼합하여 지속적으로 정주(3군)하여 다음과 같은 결과를 얻었다. 1) 각군에서 모두 혈압과 맥박의 의의있는 변화는 초래하지 않았다. 2) Visual analogue scale으로 평가한 진통 발현은 각군에서 모두 비슷하였다. 3) Visual analogue scale과 Prince Henry Scale로 평가한 진통효과는 morphine군에서 가장 우수하였고, buprenorphine군과 buprenorphine+ketorolac의 반량 투여군에서는 비슷하였다. 4) 부작용의 발생은 1군과 2군에서 비슷하였으나 3군에서 가장 낮았다. 이상의 결과로 보아 지속적 정주에 의한 술후 통증의 억제에 있어서 buprenorphine은 morphine을 대치할 수는 있으나 morphine보다 우수하지는 못한 것으로 사료되며, buprenorphine 사용시는 ketorolac을 병용하여 사용량을 줄염으로써 부작용을 줄일 수 있을 것으로 사료된다.