DOUBLE-BLIND COMPARISON OF THE MORPHINE SPARING EFFECT OF CONTINUOUS AND INTERMITTENT I.M. ADMINISTRATION OF KETOROLAC

The morphine sparing effect of ketorolac 10 mg administered4-hourly by intermittent i.m. injection was compared with acontinuous i.m. infusion in a double-blind, placebo-controlledtrial in patients undergoing upper abdominal surgery. Duringthe 48-h postoperative period, each patient was provided witha patientcontrolled analgesia (PCA) system which delivered bolusdoses of morphine and administered the intermittent i.m. dosesautomatically via a computer controlled pump. In the first 24h after surgery, there was a significant reduction in morphinedemanded by both groups receiving ketorolac compared with placebo.Patients who received a continuous infusion of ketorolac afterabdominal surgery required a median dose of morphine by PCAwhich was 49% less than controls. In the second 24 h and overthe entire 48 h of the study, patients in the continuous grouprequired significantly less morphine than those in the placebogroup. The intermittent group used less than the placebo group,but this was not significant.