BMJ 2000;321:1236-1237 ( 18 November )

Editorials

Ketorolac versus morphine for severe pain

Ketorolac is more effective, cheaper, and has fewer side effects

papers p 1247

The first 150 words of the full text of this article appear below.

Morphine, titrated intravenously, is the gold standard analgesic for severe pain in emergencies. It is effective and cheap. But morphine has well documented side effects including drowsiness, nausea and vomiting, and respiratory depression. These side effects can be distressing for patients who are already in severe pain and can also interfere with the efficient flow of patients through emergency departments. Staff must spend time observing patients who are experiencing side effects; the length of the patient's stay in the emergency department is prolonged; and some patients need to be admitted for a short time while they recover from the side effects of morphine, thus adding to overall costs.

Non-steroidal anti-inflammatory drugs have had the potential to replace opioids in the treatment of severe pain since they became available for use by intravenous injection. The only Cochrane review on this subject shows that non-steroidal anti-inflammatory drugs relieve the pain of renal . . . [Full text of this article]
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Relevant Article

Cost effectiveness analysis of intravenous ketorolac and morphine for treating pain after limb injury: double blind randomised controlled trial
Timothy H Rainer, Philip Jacobs, Y C Ng, N K Cheung, Michael Tam, Peggo K W Lam, Robert Wong, and Robert A Cocks
BMJ 2000 321: 1247. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

  • Price, C J S, Spalding, T J W, McKenzie, C, Farquharson-Roberts, M (2002). Patterns of illness and injury encountered in amateur ocean yacht racing: an analysis of the British Telecom Round the World Yacht Race 1996-1997 * Commentary. Br. J. Sports. Med. 36: 457-462 [Abstract] [Full text]  
  • (2001). Ketorolac or Morphine Analgesia: Which Is More Cost-Effective?. JWatch Emergency Med. 2001: 4-4 [Full text]  

Rapid Responses:

Read all Rapid Responses

KETOROLAC ALSO IN MEDICAL CAUSES OF SEVERE PAIN?
Srikant Gadwalkar
bmj.com, 19 Nov 2000 [Full text]
ketorolac - as safe as proposed?
John Peacock
bmj.com, 22 Nov 2000 [Full text]
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