Retrospective Case-Control Evaluation of the Use of Parenteral Ketorolac Tromethamine in Patients After Surgery

Abstract

The aim of this study was to assess medication usage and to determine differences in selected outcomes in patients who received either parenteral ketorolac tromethamine or narcotics after surgery. A retrospective case-control study was used in patients on a surgery service who were postoperative. Forty patients who received parenteral ketorolac tromethamine as their primary postoperative pain medication were matched by surgical procedure, age, and sex to 40 patients who did not receive parenteral or oral ketorolac tromethamine. Patient data were collected by chart review, and fiscal information was obtained through hospital computer data bases. Simple t-tests were used to examine between-group differences in outcomes measured by interval scales, and contingency table analyses using the chi-square statistic were used to examine differences in dichotomous and ordinal scale outcomes. Parenteral ketorolac was prescribed in accordance with Food and Drug Administration (FDA)-approved guidelines 55% of the time, but actual patient use was in accordance with FDA guidelines 75% of the time. There were no differences between groups in any measure of analgesia prescription. Significant findings between patients receiving ketorolac tromethamine versus controls included a longer length of hospital stay (14.6 ± 13.0 v 9.2 ± 8.3 days), higher pharmacy cost (69.57 ± $87.00 v $5.20 ± $6.10), and higher use of nistamine-2 antagonists (59.0% v 35.0%). Subgroup analysis showed that patients with a principle gastrointestinal diagnosis had the greatest differences in length of stay. Prospective studies are needed to assess patient outcomes when parenteral ketorolac tromethamine is prescribed for postoperative pain.