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Subcutaneous ketorolac--a new development in pain control

N Blackwell1, L Bangham, M Hughes

  • 1Mount Vernon Hospital, Northwood, Middlesex, UK.

Palliative Medicine
|January 1, 1993
PubMed
Summary
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Continuous subcutaneous ketorolac effectively managed pain in advanced cancer patients when opioids failed or caused side effects. This nonsteroidal anti-inflammatory drug significantly reduced or eliminated opioid use, improving symptom control.

Area of Science:

  • Oncology
  • Pain Management
  • Pharmacology

Background:

  • Opioid analgesia is standard for advanced malignant disease pain.
  • Opioid effectiveness can be limited by unresponsiveness or adverse effects.
  • Novel strategies are needed for refractory cancer pain.

Observation:

  • Seven patients with advanced cancer experienced inadequate pain control with opioids.
  • Reasons included opioid unresponsiveness, adverse effects, or both.
  • Continuous subcutaneous ketorolac was administered to these patients.

Findings:

  • All seven patients achieved complete symptom relief with ketorolac.
  • Four patients were able to cease opioid use entirely.
  • Three patients experienced a substantial reduction in their daily opioid requirement.

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Implications:

  • Continuous subcutaneous ketorolac is a viable alternative for managing refractory cancer pain.
  • This approach can significantly decrease opioid dependence and associated side effects.
  • Further research into non-opioid analgesics for advanced disease is warranted.