Systematic review and meta-analysis found no difference in analgesic effect or adverse effects of lower ketorolac doses in patients, suggesting safety in reduced dosing.
Ketorolac, a non-steroidal anti-inflammatory drug, is proposed to have a ceiling effect. We studied if ketorolac at lower doses was as effective and safe as the standard doses. Randomized trials on different doses of ketorolac were searched in MEDLINE, Embase, Scopus, and Web of Science from the inception date to 12 December 2024. The extent of change in pain, pain relief, need for rescue analgesia, reduction in patient opioid consumption, and adverse event rates were outcomes of interest. The risk of bias was assessed using the Cochrane Risk of Bias tool version 2. In acute, postoperative, and cancer pain, there was no difference in the analgesic effect of lower doses of ketorolac in comparison to routine doses. In addition, the results did not show higher adverse effects. www.crd.york.ac.uk/prospero identifier is CRD42023480153.
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Bahreini et al. (2025) studied this question.
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