ENHANCEMENT OF PAIN CONTROL WITH KETOROLAC TROMETHAMINE IN PATIENTS WITH SICKLE-CELL VASOOCCLUSIVE CRISIS

Twenty one patients with sickle cell disease admitted to the hospital with the pain of vaso-occlusive crisis (VOC) were treated by continuou s IV infusion of ketorolac or normal saline for up to 5 days. All pati ents received supplemental IM injections of meperidine, 100 mg, as nec essary, but not more frequently than every 3 hr. Over the 5 days the k etorolac treated patients (KT) required 33% less meperidine than did t he placebo treated patients (PL), P = 0.04, and had significantly bett er pain relief as assessed by categorical, visual analog, and pain rel ief scales. By the end of 5 days infusions had been discontinued in si x KT and one PL. The time to discontinuation of the infusion was signi ficantly shorter in KT, (P = 0.009). The median duration of hospital s tay from the start of treatment was 3.3 days for KT and 7.2 days for P L, P = 0.027. Adverse events were mainly related to the digestive syst em. This study showed that continuous infusion of ketorolac significan tly reduced total meperidine requirement and that the analgesia produc ed by this combination was superior to that produced by meperidine alo ne. Further evaluation of this drug in the management of sickle cell V OC is warranted. (C) 1494 Wiley-Liss, Inc.