Intranasal ketorolac for acute postoperative pain

Singla, Neil; Singla, Sonia; Minkowitz, Harold S.; Moodie, John; Brown, Colin R.

doi:10.1185/03007995.2010.495564

Cited by 42 publications

(31 citation statements)

References 23 publications

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“…Ketorolac absorbed through the nasal mucosa was well tolerated and an analgesic effect was achieved within 20 min, without the side effects of morphine-like painkillers. Ketorolac relieves pain through inhibition of arachidonic acid synthesis at the level of cyclooxygenase and has no central opioid effects, making it relatively safe for clinical use [21]. In this study, none of the 95 patients treated with 5% ketorolac tromethamine had any drug allergies or other adverse drug reactions.…”

Section: Discussionmentioning

confidence: 83%

Ketorolac Tromethamine Spray Prevents Postendotracheal-Intubation-Induced Sore Throat after General Anesthesia

Yang

Liu

Tsai

et al. 2016

BioMed Research International

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Background. Postoperative sore throat is one of the major complaints of general anesthesia in the postanesthesia care unit. This prospective study investigated the preventive effect of ketorolac tromethamine spray in postendotracheal-intubation-induced sore throat after general anesthesia. Methods. Surgical patients undergoing general anesthesia with endotracheal intubation were recruited from a medical center. Patients were randomly assigned to group K (treated with 5% ketorolac tromethamine spray) or group D (treated with distilled water spray). Before intubation, each endotracheal tube was sprayed with the appropriate solution by physicians over the 20 cm length of the cuff. Each group comprised 95 patients fitting the inclusion and exclusion criteria for whom complete data sets were collected. The intensity of the sore throat was measured at 1, 3, 6, and 24 h after surgery, and data were compared. Results. The two groups had similar characteristics. Postoperative sore throat was significantly less frequent in group K than in group D (p < 0.001) and the pain intensity was significantly lower in group K than in group D at each time point (all p < 0.001). Conclusions. This study demonstrated that preanesthesia 5% ketorolac tromethamine spray could effectively decrease postendotracheal-intubation-induced sore throat in patients undergoing general anesthesia.

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Section: Discussionmentioning

confidence: 83%

Ketorolac Tromethamine Spray Prevents Postendotracheal-Intubation-Induced Sore Throat after General Anesthesia

Yang

Liu

Tsai

et al. 2016

BioMed Research International

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“…To date, there are a total of five published studies reporting the efficacy and safety of IN ketorolac. Three studies consisted of patients who underwent major surgery (eg, hysterectomies, hip replacements, and abdominal surgeries), one study consisted of patients who underwent major dental surgery (eg, third molar extraction surgery), and phase 1 study in healthy patients assessed the pharmacokinetics and safety . Summary of major surgery studies are shown in Table .…”

Section: Resultsmentioning

confidence: 99%

Intranasal Ketorolac as Part of a Multimodal Approach to Postoperative Pain

2014

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Despite recent advances in the knowledge of pain mechanisms and pain management, postoperative pain continues to be a problem. Inadequately managed postsurgical pain has both clinical and economic consequences such as longer recovery times, delayed ambulation, higher incidence of complications, increased length of hospital stay, and potential to develop into chronic pain. Generally, opioids are the mainstay option for pain management in patients with moderate-to-severe postsurgical pain; however, opioids have significant side effects and have abuse potential. To improve patient and economic outcomes after surgery, postoperative pain guidelines have suggested incorporating a multi-modal/multi-mechanistic approach to pain treatment. A multi-modal approach is the simultaneous use of a combination of two or more (usually opioid and non-opioid) analgesics that provide two different mechanisms of actions. Utilizing a multi-modal approach may result in a greater reduction in pain vs. single therapies in addition to minimizing opioid use, thus reducing opioid related side effects. However, not all approaches may be effective for all types of patients and not all analgesics may be a viable option for outpatient settings, ambulatory surgery, or the fast-track surgical procedures. In this report, we present a review of the literature with a focus on intranasal ketorolac in order to provide a timely update regarding past, present, and future multi-modal treatment options for postoperative pain.

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“…17 A randomized controlled trial in patients after abdominal surgery showed 26% less morphine consumed in the first 48 hours postoperative. 18 Both studies remarked on the rapid onset of analgesia, which lasted up to 8 hours, 17 and suggested its benefit in ambulatory or fast-track surgery. 18 The rapid onset and improved analgesia seen with IN ketorolac may be due to higher penetration via the cribriform plate and into the cerebrospinal fluid.…”

Section: Nsaidsmentioning

confidence: 98%

“…18 Both studies remarked on the rapid onset of analgesia, which lasted up to 8 hours, 17 and suggested its benefit in ambulatory or fast-track surgery. 18 The rapid onset and improved analgesia seen with IN ketorolac may be due to higher penetration via the cribriform plate and into the cerebrospinal fluid. Higher cerebrospinal fluid levels of NSAIDs have been associated with greater analgesia.…”

Section: Nsaidsmentioning

confidence: 98%