The Effect of Continuous Infusion of Ketorolac on Morphine IV PCA

Choi, Duck Hwan; Chung, Ik Soo; Kim, Seung Oh

Abstract

BACKGROUND
Ketorolac (TarasynR) 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 ketomlac 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 inovement. 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.