IV ketorolac may reduce pain, opioid use in patients with polytrauma
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Key takeaways:
- Patients who received IV Ketorolac during a 5-day period had reduced pain.
- Patients who received IV Ketorolac also had reduced opioid intake vs. the saline group.
SEATTLE — Use of IV ketorolac in patients who have polytrauma may reduce pain, as well as opioid intake, according to data presented at the Orthopaedic Trauma Association Annual Meeting.
“This is the first randomized clinical study to look at IV ketorolac in orthopedic polytrauma patients,” Arun Aneja, MD, PhD, said in his presentation. “We feel that it has a role in the multimodal analgesia.”
Aneja and colleagues randomly assigned 70 patients aged 18 to 75 years with polytrauma and a New Injury Severity Score greater than nine to receive either 15 mg of IV ketorolac every 6 hours or 2 mL of saline every 6 hours. Outcomes included hospital length of stay, opioid usage and VAS pain scores.
“The reason why we chose ketorolac is it is readily available; it has been approved since the late 1980s in IV form; it is safe and effective as morphine in multiple studies, particularly in [gastrointestinal] GI abdominal literature; it obviates some of the limitations of the oral intakes and out of all the NSAIDs, it has better hemodynamic profiles,” Aneja said.
According to Aneja, the two groups had no significant differences in length of hospital stay. He added patients in the treatment group had a 30% decrease in opioid intake, as well as a 12-point reduction in VAS pain scores.
“We were underpowered to look at fracture healing and union with this study,” Aneja said. “Nonetheless, we feel that in certain populations of opioid-naive polytrauma patients, ketorolac has a role in controlling inpatient acute pain.”
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Aneja A, et al. Paper 93. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 18-21, 2023; Seattle.
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