April 1, 1997Anesthesia & Analgesia
The Addition of Continuous Intravenous Infusion of Ketorolac to a Patient-Controlled Analgetic Morphine Regime Reduced Postoperative Myocardial Ischemia in Patients Undergoing Elective Total Hip or Knee Arthroplasty
Why the study?
Does the addition of continuous intravenous ketorolac to PCA morphine reduce postoperative myocardial ischemia in patients undergoing elective total hip or knee arthroplasty?
Population
Patients undergoing elective total hip or knee arthroplasty
Comparison
Ketorolac 30 mg intravenous bolus, followed by… vs Placebo added to patient-controlled analgesia…
Design
RCT, randomized, double-blind
Follow-up
24 hours
Authors
Discussion
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Member takes
Implication
Supports adjunctive ketorolac for reducing postoperative ischemic burden in arthroplasty; extends NSAID evidence to silent myocardial ischemia.
Structured PICO
Does the addition of continuous intravenous ketorolac to PCA morphine reduce postoperative myocardial ischemia in patients undergoing elective total hip or knee arthroplasty?
P
Population
Patients undergoing elective total hip or knee arthroplasty
I
Intervention
Ketorolac 30 mg intravenous bolus, followed by continuous infusion of 5 mg/h for 24 h, added to patient-controlled analgesia (PCA) morphine (20 microg/kg bolus, 6 min lockout)
C
Comparator
Placebo added to patient-controlled analgesia (PCA) morphine (20 microg/kg bolus, 6 min lockout)
O
Outcome
Postoperative myocardial ischemia (ST segment depression of 1 mm 60 ms after the J point lasting >1 min via continuous Holter monitor), analgesia (pain visual analog scale), heart rate, and arterial blood pressuresurrogate
Adding continuous intravenous ketorolac to PCA morphine reduces the duration of silent postoperative myocardial ischemic episodes in patients undergoing major joint arthroplasty.
Cite This Study
Beattie et al. (1997) studied this question.