Brown C R, Moodie J E, Wild V M, Bynum L J
Waikato Analgesic Research, Hamilton, New Zealand.
Pharmacotherapy. 1990;10(6 ( Pt 2)):116S-121S.
This study compared the efficacy and safety of ketorolac tromethamine and morphine sulfate in alleviating moderate or severe pain immediately after major surgery. One hundred twenty-two patients were randomly assigned to receive single intravenous injections of ketorolac 10 mg, ketorolac 30 mg, morphine 2 mg, or morphine 4 mg; patients could receive a second dose 15 minutes thereafter, upon request, and most received both available doses. Analgesic efficacy was measured by interviewing patients and assessing pain intensity and pain relief for 6 hours after the first medication administration. The two drugs showed a similar onset of action, peaking 1 hour after administration. When placed in order of descending efficacy, the mean scores for most efficacy measures fell into the following sequence: ketorolac 30 mg, ketorolac 10 mg, morphine 4 mg, and morphine 2 mg. There were no statistically significant differences among the two ketorolac doses and the high dose of morphine, but all three of these treatments were significantly superior to the low morphine dose. One patient who took morphine 4 mg withdrew because of drowsiness; other common adverse events reported included nausea, vomiting, somnolence, and dyspepsia. There were no statistically significant differences in the frequency of adverse events among the treatment groups. Intravenous ketorolac is effective for the treatment of postoperative pain.
本研究比较了酮咯酸氨丁三醇和硫酸吗啡在缓解大手术后即刻中度或重度疼痛方面的疗效和安全性。122例患者被随机分配接受单次静脉注射10 mg酮咯酸、30 mg酮咯酸、2 mg吗啡或4 mg吗啡；患者可在15分钟后根据需要接受第二剂，大多数患者接受了两剂。通过询问患者并评估首次用药后6小时的疼痛强度和疼痛缓解情况来测量镇痛效果。两种药物起效时间相似，给药后1小时达到峰值。按疗效从高到低排序，大多数疗效指标的平均得分顺序如下：30 mg酮咯酸、10 mg酮咯酸、4 mg吗啡和2 mg吗啡。两种酮咯酸剂量与高剂量吗啡之间无统计学显著差异，但这三种治疗均显著优于低剂量吗啡。1例服用4 mg吗啡的患者因嗜睡退出；报告的其他常见不良事件包括恶心、呕吐、嗜睡和消化不良。各治疗组不良事件发生率无统计学显著差异。静脉注射酮咯酸对治疗术后疼痛有效。
