SPRIX in 0 to 11 Year-Old Patients Undergoing Open Surgical Procedures

Inclusion Criteria:

- Male or female patients ages 0 to 11 years.

- Undergoing an open surgical procedure expected to result in at least moderate pain
based on an age appropriate scale.

- Body mass index (BMI) ≤ 95th percentile of age.

- Surgical procedures that would allow the subject to likely remain in the hospital
until the morning of post-operative day 3 (to complete PK sample collection).

- With parental assistance, willing and able to complete the study procedures and pain
scales and to communicate meaningfully with the study personnel.

- In generally good health and capable of undergoing surgery.

- Females at risk of pregnancy were to use an acceptable form of birth control and have
a negative serum or urine pregnancy test (although it is anticipated that all 0-11
year old subjects will be pre-menarchal).

- Willing to refrain from use of non-study analgesics for the duration of the study,
from the day of surgery up to post-operative Day 4.

- Assents to participation and his/her parent or guardian is willing and able to sign
the informed consent approved by the IRB.

Exclusion Criteria:

- Surgical procedure performed exclusively by laparoscopy.

- Known allergy or sensitivity to ketorolac, ethylene diamine tetraacetic acid (EDTA).

- Prior nasal-septal injury or surgery.

- History of peptic ulcer, gastro-esophageal reflux, or gastrointestinal bleeding.

- History of advanced renal impairment or a risk for renal failure due to volume
depletion.

- Clinically significant (in the Investigator's opinion) laboratory test value outside
the normal range.

- Use of either (a.) oxycodone at a dose of 30 mg/day or more or (b.) an equivalent
dose of another opioid analgesic for a total of more than half of the days during the
preceding month.

- The patient requires regular use (daily use in at least 25 days per month) in the 3
months prior to surgery of NSAID's , COX2 inhibitors, tramadol, or acetaminophen at
daily dose of more than 2 g for the management of pain.

- Contraindication to the use of morphine, general anesthetics, bupivacaine,
ropivacaine, lidocaine, other local anesthetics, muscle relaxants, hydrocodone,
ondansetron, or acetaminophen (e.g., significant history of allergic reactions or
intolerance to these or related substances).

- Known bleeding diathesis or other disorder or current use of agents affecting
coagulation. Deep venous thrombosis prophylaxis of the surgeon's choice is permitted
postoperatively.

- Current use of Central Nervous System (CNS) active drugs such as benzodiazepines,
tricyclic antidepressants, or Selective Serotonin Reuptake Inhibitors (SSRIs) for
pain. These drugs are permitted for non-pain indications if the dose has been stable
for at least 30 days. The use of lorazepam and other sleep medications, except those
containing analgesic properties, are permitted.

- Current diabetes mellitus and HbA1C > 9.5 or a history of prolonged uncontrolled
diabetes.

- Use of an antihypertensive agent or diabetic regimen at a dose that has not been
stable for at least 30 days.

- Any medical condition that in the investigator's opinion could adversely impact the
patient's participation or safety, conduct of the study, or interfere with the pain
assessments, including active infection.

- History of drug, prescription medicine, or alcohol abuse that would interfere with
the subject's safety or the assessments of efficacy in this trial, in the judgement
of the investigator.

- History of nasal mucosal damage or active seasonal allergies, nasal congestion or
upper respiratory tract infection sufficient to interfere with intranasal drug
delivery.

- Administration of an investigational product within 3 months prior to the first dose
of study drug, or scheduled to receive an investigational product, while
participating in the study.

- Use of Toradol (ketorolac tromethamine) in any formulation within the past 30 days
prior to study entry and throughout study participation.