Ketorolac as a premedicant for coronary artery bypass surgery patients with normal ventricles

Premedication of patients requiring cardiac surgery should provide adequate analgesia, sedation and anxiolysis for the stress and pain associated with preoperative preparation and placement of monitoring catheters. Ideally, these effects would be achieved without producing respiratory depression and hypoxia, which could be life-threatening to patients at risk for myocardial ischemia. Ketorolac, a nonsteroidal, antiinflammatory agent, has previously been shown to provide postoperative pain relief comparable to that provided by morphine, without respiratory depression. This study compared the incidence of arterial blood desaturation, respiratory depression, and patient comfort after preoperative medication with scopolamine and ketorolac versus scopolamine and morphine. Scopolamine and ketorolac premedication provided sedation and analgesia comparable to that provided by scopolamine and morphine, without significant respiratory depression. Since ketorolac has no central respiratory depressant effect, it may be a useful alternative to morphine for premedication in the cardiac surgical patient.