Ketorolac for sickle cell vaso-occlusive crisis pain in the emergency department: lack of a narcotic-sparing effect.

STUDY OBJECTIVE

To determine if a single dose of intramuscular ketorolac given on presentation to the emergency department has a narcotic-sparing effect in adult patients with sickle cell vaso-occlusive crisis pain.

DESIGN

A prospective, randomized, single-dose, double-blind study.

SETTING

ED of a university hospital and an affiliated county hospital.

TYPE OF PARTICIPANTS

Eighteen adult patients who presented to the ED with sickle cell crisis pain a total of 24 times.

INTERVENTIONS

Patients were randomized to receive either ketorolac 60 mg IM or placebo on presentation to the ED. Subjects were administered meperidine on presentation and then received a standardized dose of meperidine every 30 minutes during the four-hour observation period based on the severity of pain.

MEASUREMENTS AND MAIN RESULTS

The 12 subjects in the ketorolac group received an average of 231 +/- 92 mg meperidine, whereas the 12 subjects in the placebo group received an average meperidine dose of 250 +/- 85 mg (P = .61).

CONCLUSION

The use of intramuscular ketorolac did not lead to a clinically significant reduction in the requirement for narcotics during the four-hour ED treatment period.