INTRAVENOUS KETOROLAC FOR PAIN MANAGEMENT IN A VENTILATOR-DEPENDENT PATIENT WITH THERMAL-INJURY

A patient with a long-standing history of chronic obstructive pulmonar y disease suffered a thermal injury over 20% of his total body surface area. He required opiates for pain management and benzodiazepines for anxiety associated with dressing changes. The narcotics compromised h is pulmonary function and level of consciousness, and interfered with several attempts to wean him from ventilator support. Intravenous keto rolac instead of narcotics before dressing changes alleviated the resp iratory depression and returned his partial pressure of carbon dioxide -mediated respiratory drive to normal. With these changes, including c hanges in respiratory rate to tidal volume, he was successfully weaned from ventilatory support. In addition, the patient's level of conscio usness improved. These changes increased his participation in his dail y physical therapy sessions.