Seyed Mohammad Hosseininejad; Hamed Amini Ahidashti; Farzad Bozorgi; Iraj Goli Khatir; Seyed Hosein Montazer; Fatemeh Jahanian; Mehran Amooei Khanabbasi
Volume 5, Issue 3 , July 2017, , Pages 165-170
Abstract
Objective: To compare the efficacy of combination therapy with ketorolac and morphine with monotherapy with each in patients with acute renal colic. Methods: This triple-blind, randomized clinical trial was conducted during a 6-month period from March to September 2014 in Northern Iran. We included ...
Read More
Objective: To compare the efficacy of combination therapy with ketorolac and morphine with monotherapy with each in patients with acute renal colic. Methods: This triple-blind, randomized clinical trial was conducted during a 6-month period from March to September 2014 in Northern Iran. We included 300 patients with clinical diagnosis of acute renal colic and pain score greater than 4 on 10 cm visual analogue scale (VAS) score. Patients were randomly assigned to three study groups to receive 0.1 mg/kg morphine in combination with 30 mg ketorolac (n=100), or only 0.1 mg/kg morphine (n=100) or only 30mg ketorolac (n=100). All the patients were evaluated at 0, 20 minute,40 minute later. Our outcomes were pain reduction and need for additive morphine in 20 and 40 minutes. We also recorded and compared the adverse effects between the study groups.Results: There was no significant difference between the study groups. The pain intensity was comparable between three study groups after 20-min of intervention. However, we found that the pain intensity was significantly lower in balanced analgesia group when compared to morphine (3.01±0.98 vs. 3.66±1.02; p=0.012) or ketorolac alone (3.01±0.98 vs. 3.68±0.88; p=0.018). However, those receiving the balanced analgesia, required significantly less rescue analgesia when compared to morphine (16% vs. 20%; p=0.041) or ketorolac (16% vs. 24%; p=0.012) alone. Conclusion: Balanced analgesia with morphine and ketorolac is more effective compared to morphine or ketorolac alone determine by lower pain scores after 40-min of injection and lower need for rescue analgesia.
Hamid Reza Eftekharian; Homa Ilkhani pak
Volume 5, Issue 1 , January 2017, , Pages 13-17
Abstract
Objective: To evaluate the effects of intravenous ketorolac on early postoperative pain in patients with mandibular fractures, who underwent surgical repair.Methods: This prospective, randomized, placebo-controlled clinical trial was conducted in Shahid Rajaei Hospital, affiliated with Shiraz University ...
Read More
Objective: To evaluate the effects of intravenous ketorolac on early postoperative pain in patients with mandibular fractures, who underwent surgical repair.Methods: This prospective, randomized, placebo-controlled clinical trial was conducted in Shahid Rajaei Hospital, affiliated with Shiraz University of Medical Sciences during a 1-year period from 2015 to 2016. We included a total number of 50 patients with traumatic mandibular fractures who underwent surgical repair. Patients with obvious contraindications to ketorolac such as asthma, renal dysfunction, peptic ulceration, bleeding disorders, cardiovascular disease, mental retardation, or allergy to ketorolac or NSAIDS, were excluded. The patients were randomly assigned to receive intravenous ketorolac (30 mg) at the end of operation in post anesthesia care unit immediately upon the onset of pain (n=25), or intravenous distilled water as placebo (n=25). Postoperative monitoring included non-invasive arterial blood pressure, ECG, and peripheral oxygen saturation. The postoperative pain was evaluated by a nurse using visual analog scale (VAS) (0–100 mm) pain score 4 hours after surgery and was compared between the two study groups.Results: Overall we included 50 patients (25 per group) in the current study. The baseline characteristics including age, gender, weight, operation duration, anesthesia duration and type of surgical procedure were comparable between two study groups. Those who received placebo had significantly higher requirements for analgesic use compared to ketorolac group (72% vs. 28%; p=0.002). Ketorolac significantly reduced the pain intensity 30-min after the operation (p<0.001). There were no significant side effects associated with ketorolac.Conclusion: Intravenous single-dose ketorolac is a safe and effective analgesic agent for the short-term management of mild to moderate acute postoperative pain in mandibular fracture surgery and can be used as an alternative to opioids.
