How much ketorolac do you need to treat a patient’s pain? Historically, it’s been 60mg IM and 30 mg IV. In press in the Annals of Emergency Medicine - Comparison of Intravenous Ketorolac at Three Single-Dose Regimens for Treating Acute Pain in the Emergency Department: A Randomized Controlled Trial found that 10 mg IV was equal in analgesia to 15 and 30 mg. So is more better? In this case, probably not.
Shawn D. - December 17, 2016 1:55 PM
Great segment. Excellent topic and one that I've been trying to convince our analgesia committee to get onboard with (low dose ketorolac). Can you include the reference to the article? I believe the data was presented at SAEM this year but would be nice to review the article (and unfortunately I can't find it on pubmed).
Rob O - December 17, 2016 2:48 PM
Hey Shawn, so far unable to find on pubmed but here is a link to the full article on annals of em site http://www.annemergmed.com/article/S0196-0644(16)31244-6/fulltext
Shawn D. - December 17, 2016 5:05 PM
Perfect! Thank you.
Luis R. - December 30, 2016 12:09 AM
I usually use, 15 IV and 30 IM, I read an article before, which shows 7.5 mg IV hit close to the threshold of analgesia so doesn't matter if u give more is the same no difference in pain control and IM 15 mg also the same.
Kara B. - January 18, 2017 5:27 AM
Ketorolac is also available is a 15 mg/ml vial, so a little less waste there.
brendan c. - March 20, 2017 9:39 PM
Who was tested?
Was there degree of pain control adequate in the treated condition
What were the conditions treated?
I give Tordaol for renalcolic that is refusing opioids .It help alot and I will not t change.
SIDE EFFECTS? it would take a massive trial to determine how important or common siode effects exist: MY guess is .................NONE. Err on the side of compassion and kindness. This whole topic is a joke in the real world. Come se us in the REAL WORLD
Rob O - March 21, 2017 1:00 PM
Hi Brendan, Thanks for writing in. I think this has real world implications in finding the therapeutic ceiling of a commonly used analgesic. The follow up question is whether the increasing doses above the maximally effective dose causes commensurate side effects. This study certainly doesn't address that quesiton
Alexander M. - March 28, 2017 11:17 AM
There's side effects to ketorolac. Acute tubular necrosis. I've seen it several times 'in the real world'.
Seema M. - November 27, 2017 8:56 PM
In the original article, were any of the patients followed for greater than 120 minutes?
ie, how long-lasting was the pain relief?