Transdermal fentanyl system plus im ketorolac for the treatment of postoperative pain

Douglas J. Reinhart, Michael E. Goldberg, Jonathan V. Roth, Rita Dua, Igal Nevo, Kevin W. Klein, Marc Torjman, Denis Vekeman

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose: To assess the safety and efficacy of transoermal fentanyl plus im ketorolac vs im ketorolac alone in the treatment of postoperative pain. Methods: Ninety-two patients scheduled for surgery involving moderate to severe postoperative pain were randomized to one of two groups. Group A (n=46) received an active fentanyl patch and group P (n=46) received a placebo patch. Patches remained in place for 24 hr. Each patient received intraoperative ketorolac, 60 mg im. Patients were monitored for 36 hr postoperatively and the groups were analyzed for ketorolac usage, pain scores. vital signs, serum fentanyl concentrations, and adverse events. Intramuscular ketorolac was available on demand. Results: Group A had lower pain scores at 8, 12, 16 and 24 hr after patch placement (P< 0.05). Group A had lower heart rates, lower respiratory rates and fewer dropouts due to inadequate pain relief (4.3% vs 21.7%, P< 0.05). Group A patients also used less ketorolac than group P patients (P< 0.05). The incidence of pruntus was higher in group A patients (19%vs 2%, P< 0.05), while the incidence of nausea and vomiting was not different between the two groups. Transdermal fentanyl was adequate "stand-alone" analgesia in only 23.8% of group A patients while 93.7% of the remaining group A patients receiving a combination of transdermal fentanyl and ketorolac had adequate pain relief. Conclusion: The transdermal fentanyl delivery system plus ketorolac im was more effective in controlling postoperative pain than ketorolac im alone. The two treatment modalities were comparable in safety with no difference in serious adverse events.

Original languageEnglish (US)
Pages (from-to)377-384
Number of pages8
JournalCanadian Journal of Anaesthesia
Volume44
Issue number4
DOIs
StatePublished - Apr 1997

Fingerprint

Ketorolac
Fentanyl
Postoperative Pain
Pain
Therapeutics
Safety
Vital Signs
Incidence
Respiratory Rate
Analgesia
Nausea
Vomiting
Heart Rate
Placebos

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Reinhart, D. J., Goldberg, M. E., Roth, J. V., Dua, R., Nevo, I., Klein, K. W., ... Vekeman, D. (1997). Transdermal fentanyl system plus im ketorolac for the treatment of postoperative pain. Canadian Journal of Anaesthesia, 44(4), 377-384. https://doi.org/10.1007/BF03014457

Transdermal fentanyl system plus im ketorolac for the treatment of postoperative pain. / Reinhart, Douglas J.; Goldberg, Michael E.; Roth, Jonathan V.; Dua, Rita; Nevo, Igal; Klein, Kevin W.; Torjman, Marc; Vekeman, Denis.

In: Canadian Journal of Anaesthesia, Vol. 44, No. 4, 04.1997, p. 377-384.

Research output: Contribution to journalArticle

Reinhart, DJ, Goldberg, ME, Roth, JV, Dua, R, Nevo, I, Klein, KW, Torjman, M & Vekeman, D 1997, 'Transdermal fentanyl system plus im ketorolac for the treatment of postoperative pain', Canadian Journal of Anaesthesia, vol. 44, no. 4, pp. 377-384. https://doi.org/10.1007/BF03014457
Reinhart, Douglas J. ; Goldberg, Michael E. ; Roth, Jonathan V. ; Dua, Rita ; Nevo, Igal ; Klein, Kevin W. ; Torjman, Marc ; Vekeman, Denis. / Transdermal fentanyl system plus im ketorolac for the treatment of postoperative pain. In: Canadian Journal of Anaesthesia. 1997 ; Vol. 44, No. 4. pp. 377-384.
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abstract = "Purpose: To assess the safety and efficacy of transoermal fentanyl plus im ketorolac vs im ketorolac alone in the treatment of postoperative pain. Methods: Ninety-two patients scheduled for surgery involving moderate to severe postoperative pain were randomized to one of two groups. Group A (n=46) received an active fentanyl patch and group P (n=46) received a placebo patch. Patches remained in place for 24 hr. Each patient received intraoperative ketorolac, 60 mg im. Patients were monitored for 36 hr postoperatively and the groups were analyzed for ketorolac usage, pain scores. vital signs, serum fentanyl concentrations, and adverse events. Intramuscular ketorolac was available on demand. Results: Group A had lower pain scores at 8, 12, 16 and 24 hr after patch placement (P< 0.05). Group A had lower heart rates, lower respiratory rates and fewer dropouts due to inadequate pain relief (4.3{\%} vs 21.7{\%}, P< 0.05). Group A patients also used less ketorolac than group P patients (P< 0.05). The incidence of pruntus was higher in group A patients (19{\%}vs 2{\%}, P< 0.05), while the incidence of nausea and vomiting was not different between the two groups. Transdermal fentanyl was adequate {"}stand-alone{"} analgesia in only 23.8{\%} of group A patients while 93.7{\%} of the remaining group A patients receiving a combination of transdermal fentanyl and ketorolac had adequate pain relief. Conclusion: The transdermal fentanyl delivery system plus ketorolac im was more effective in controlling postoperative pain than ketorolac im alone. The two treatment modalities were comparable in safety with no difference in serious adverse events.",
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