A
PROSPECTIVE STUDY COMPARING I.M. KETOROLAC WITH I.M. MEPERIDINE IN THE
TREATMENT OF ACUTE BILIARY COLIC
Dula
DJ, Anderson R, Wood GC. J Emerg Med 2001 Feb;20(2):121-4
BACKGROUND:
Ketorolac is a nonsteroidal anti-inflammatory medication that is used widely
for pain management. Its effects are mediated through the inhibition of
prostaglandins, which makes it uniquely different from opioids in relieving
pain.
METHODS:
We conducted a randomized, prospective, double blind study of patients
presenting to our Emergency Department (ED) with a diagnosis of acute biliary
colic. Study patients were randomized into one of two treatment groups,
meperidine 1.5 mg/kg with a maximum dose of 100 mg or ketorolac 60 mg given
intramuscularly (i.m.). The patients rated their pain before and 30 min after
medication on a scale of 1 to 10 using a Visual Analog Pain Scale. Overall pain
relief was compared between the two groups using a two-sample t test.
RESULTS:
Thirty patients were enrolled in the study, 16 in the ketorolac group and 14 in
the meperidine group. Patients ranged in age from 18 to 71 years and 6 (20%)
were male. The average pain score at time 0 was 7.6 for the ketorolac group and
7.3 for the meperidine group. Pain relief at time 30 min was 3.8 in the
ketorolac group and 3.9 in the meperidine group, which was not statistically
different. The mean global pain score and need for an emergency cholecystectomy
were similar in the two groups. Rescue medication for additional analgesia at
30 min was needed in 4 patients in the meperidine group and in 2 patients in
the ketorolac group (28.6% versus 12.5%, respectively; NS).
CONCLUSION:
In this study of patients with acute biliary colic there was no significant
difference in the pain relief achieved by using either ketorolac or meperidine.