Abstract
Ketorolac tromethamine is a newly available non-steroidal anti-inflammatory drug which is suitable for parenteral administration. We have given it by continuous subcutaneous infusion to 36 patients with pain due to advanced cancer. Improvement in pain control occurred in 29 (80%). A reduction in the dose of concomitant opioid analgesia was possible in 22 (76%) and a reduction in opioid-related adverse effects occurred in 16 (73%) of these. Ketorolac was most effective in patients who had bone or visceral pain. It was mixed safely with diamorphine in a syringe driver at concentrations up to 4 g diamorphine/10 ml and 120 mg ketorolac/10 ml. Infusion was well tolerated for periods of up to 115 days (mean 21 days; median 15 days; range 3-115 days). Four patients experienced gastrointestinal bleeding and one colonic perforation to which treatment with ketorolac may have been a contributory factor. No other clinically significant adverse effects were observed.
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Selected References
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- Blackwell N., Bangham L., Hughes M., Melzack D., Trotman I. Subcutaneous ketorolac--a new development in pain control. Palliat Med. 1993;7(1):63–65. doi: 10.1177/026921639300700110. [DOI] [PubMed] [Google Scholar]
- Fricke J. R., Jr, Angelocci D., Fox K., McHugh D., Bynum L., Yee J. P. Comparison of the efficacy and safety of ketorolac and meperidine in the relief of dental pain. J Clin Pharmacol. 1992 Apr;32(4):376–384. doi: 10.1002/j.1552-4604.1992.tb03850.x. [DOI] [PubMed] [Google Scholar]
- Gillies G. W., Kenny G. N., Bullingham R. E., McArdle C. S. The morphine sparing effect of ketorolac tromethamine. A study of a new, parenteral non-steroidal anti-inflammatory agent after abdominal surgery. Anaesthesia. 1987 Jul;42(7):727–731. doi: 10.1111/j.1365-2044.1987.tb05317.x. [DOI] [PubMed] [Google Scholar]
- Hall E. Subcutaneous diclofenac: an effective alternative? Palliat Med. 1993;7(4):339–340. [PubMed] [Google Scholar]
- O'Hara D. A., Fragen R. J., Kinzer M., Pemberton D. Ketorolac tromethamine as compared with morphine sulfate for treatment of postoperative pain. Clin Pharmacol Ther. 1987 May;41(5):556–561. doi: 10.1038/clpt.1987.71. [DOI] [PubMed] [Google Scholar]
- Ventafridda V., Fochi C., De Conno D., Sganzerla E. Use of non-steroidal anti-inflammatory drugs in the treatment of pain in cancer. Br J Clin Pharmacol. 1980 Oct;10 (Suppl 2):343S–346S. doi: 10.1111/j.1365-2125.1980.tb01820.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yee J. P., Koshiver J. E., Allbon C., Brown C. R. Comparison of intramuscular ketorolac tromethamine and morphine sulfate for analgesia of pain after major surgery. Pharmacotherapy. 1986 Sep-Oct;6(5):253–261. doi: 10.1002/j.1875-9114.1986.tb03485.x. [DOI] [PubMed] [Google Scholar]