Study of Whether 15 mg Dose of Ketorolac IV is as Effective as a 30 mg Dose.

NCT ID: NCT01230463

Last Updated: 2010-10-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-09-30

Study Completion Date

2011-09-30

Brief Summary

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The primary aim of this study is to show the non-inferiority of 15 mg intraoperative dose of ketorolac as compared to the standard 30 mg ketorolac by looking at the VAS scores 4 hours after an adult spine surgery.

Detailed Description

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Opioids have traditionally been the cornerstone of acute postoperative pain management. Problematic side effects such as nausea, vomiting, ileus, urinary retention, excess sedation, and respiratory depression are significant disadvantages with the use of opioids. Alternative treatments have been sought. The concept of adding a nonsedating non opioid analgesic agent is appealing and has been validated by previous studies. Nonsteroidal anti-inflammatory drugs (NSAID) are nonsedating and combine analgesic and anti-inflammatory properties ideal for pain after surgery.

Ketorolac is a potent intravenous nonsteroidal anti-inflammatory drug (NSAID), and a non selective cyclooxygenase inhibitor which mediates pain, inflammation and fever. It has been evaluated and used for treatment of moderate to severe pain including postoperative pain. Although intravenous route is not approved by Health Canada, its use is supported in medical literature and clinical practice.

Previous studies have demonstrated the effectiveness of standard 30 mg intravenous ketorolac as an adjunct to opioids for postoperative pain relief. Standard parenteral dose recommended by manufacturer for healthy non elderly population is 30 mg based on a number clinical trials.

Alberta Health Services (AHS) Pharmacy formulary has approved the intravenous use of ketorolac in the dosage range of 10-30 mg depending the patient's weight and medical comorbidities.

NSAIDs, including ketorolac, have an analgesic ceiling effect in which higher doses do not provide any additional pain relief but may increase the likelihood of side effects. Single dose IM ketorolac have been studied in the past showing no difference in analgesia with the 30 and 90 mg dose. Because of risk of drug toxicity and unwanted side effects, patients should be given the lowest effective ketorolac dose. Low dose ketorolac was studied in the adolescents undergoing spine surgery and showed that dose of 0.2mg/kg (11mg) provides supplemental analgesia postoperatively. However, there were no previous studies found on review of the literature using medline search that look at parallel comparison between intraoperative doses of ketorolac in terms of efficacy and safety profile.

Conditions

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Pain Pain, Postoperative

Keywords

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Pain, Postoperative Ketorolac Anti-Inflammatory Agents, Non-Steroidal Intraoperative Care

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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15 mg ketorolac IV

Group Type ACTIVE_COMPARATOR

Ketorolac Tromethamine

Intervention Type DRUG

15 mg ketorolac IV as a bolus 30 minutes before closure of surgery.

30 mg ketorolac IV

Group Type ACTIVE_COMPARATOR

Ketorolac Tromethamine

Intervention Type DRUG

30 mg ketorolac IV as a bolus 30 minutes before closure of surgery.

Interventions

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Ketorolac Tromethamine

15 mg ketorolac IV as a bolus 30 minutes before closure of surgery.

Intervention Type DRUG

Ketorolac Tromethamine

30 mg ketorolac IV as a bolus 30 minutes before closure of surgery.

Intervention Type DRUG

Other Intervention Names

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Toradol Toradol

Eligibility Criteria

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Inclusion Criteria

* Patients booked for 1-2 level spine laminectomies and/or decompression
* Adult 18 - 65 years
* Weight of 50 - 110 kg

Exclusion Criteria

* Previous lumbar laminectomy
* Current anticoagulant use with INR \> 1.2
* Narcotic use \> 4 weeks
* Known allergy or sensitivity to NSAID or morphine
* Renal insufficiency with creatinine \>100 umol/L
* Known liver disease
* History of gastrointestinal bleeding
* Pregnancy, history of bronchial asthma
* NSAID use 2 days before surgery.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Calgary

OTHER

Sponsor Role lead

Responsible Party

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University of Calgary Department of Anesthesia

Principal Investigators

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Kaylene Duttchen, MD

Role: PRINCIPAL_INVESTIGATOR

University of Calgary - Department of Anesthesia

Melinda Davis, MD

Role: PRINCIPAL_INVESTIGATOR

University of Calgary - Department of Anesthesia

Locations

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Foothills Medical Centre

Calgary, Alberta, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Cecilia Deguzman, MD

Role: CONTACT

Phone: 403-944-1991

Email: [email protected]

Kevin Yee, MD

Role: CONTACT

Phone: 403-944-1991

Email: [email protected]

Other Identifiers

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23237

Identifier Type: -

Identifier Source: org_study_id