A Prospective Randomized Double-Blind Trial Comparing 3 Doses of Intravenous Ketorolac for Pain Management

Ketorolac tromethamine is a non-steroidal anti-inflammatory drug (NSAID) that is widely used
in the Emergency Department (ED) for the treatment of moderate-to-severe pain. Ketorolac is
available in both oral and parenteral forms and possess significant analgesic potency.
However, ketorolac provides few advantages over other currently available analgesics and its
use is limited by a virtue of having an "analgesic ceiling" with the dose being 10mg as well
as having a range of severe side effects, of which gastrointestinal hemorrhage is most
concerning.The concept of an analgesic ceiling is that doses beyond this value (10mg) do not
provide additional analgesia and do contribute to side effects. In spite of this, the
majority of research conducted on ketorolac in the ED and recommendations in Tintinalli's
Emergency Medicine Textbook advocating for use of three-to-six fold higher dosages.

Hypothesis: Intravenous administration of Ketorolac in a dose of 10 mg is as effective in
treating severe acute pain in patients presenting to the ED as 15 mg and 30 mg.

Inclusion Criteria:

Severe flank and abdominal pain, severe musculoskeletal pain (traumatic and non-traumatic
in origin), headache, dental pain.

Exclusion Criteria:

Age >65, Active Peptic Ulcer disease, Acute Gastrointestinal Hemorrhage, Known Hx of Renal
or Hepatic insufficiency, Hx of allergies to NSAIDS.