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 replacement
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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Implication
Supports adjunctive ketorolac to reduce postoperative ischemia after hip/knee arthroplasty; extends NSAID evidence to perioperative cardiac outcomes.
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 replacement
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 micro g/kg bolus, 6 min lockout)
C
Comparator
Placebo added to patient-controlled analgesia (PCA) morphine
O
Outcome
Analgesia (pain visual analog scale), heart rate, arterial blood pressure, and postoperative myocardial ischemia (ST segment depression via continuous Holter monitor)surrogate
Adding continuous intravenous ketorolac to PCA morphine improves pain control and reduces the duration of postoperative myocardial ischemic episodes in patients undergoing major joint arthroplasty.
Cite This Study
Beattie et al. (1997) studied this question.