Cochrane · systematic review · CD013263
Single‐dose intravenous ketorolac for acute postoperative pain in adults
McNicol, ED, Ferguson, MC, Schumann, R · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Pain, Palliative and Supportive CareAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 3 · 25%Low 5 · 41.7%Moderate 4 · 33.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Intravenous ketorolac compared to placebo for adults with acute postoperative pain
Population: adults (mean study ages 23 to 67 years) with acute postoperative pain after abdominal/pelvic, dental or orthopedic surgeries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of participants with at least 50% pain relief over 4 hours Intravenous ketorolac vs placebo | RR 2.81 [1.8, 4.37] | 8 studies · 658 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of participants with at least 50% pain relief over 6 hours Intravenous ketorolac vs placebo | RR 3.26 [1.93, 5.51] | 10 studies · 914 participants | Low Downgraded: risk of bias, inconsistency |
Median time to use of rescue medication Intravenous ketorolac vs placebo | no estimate extracted | 6 studies · 633 participants | Moderate Downgraded: risk of bias, imprecision |
Number of participants using rescue medication over 4 or 6 hours post‐interventions Intravenous ketorolac vs placebo | RR 0.6 [0.36, 1] | 5 studies · 417 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of participants reporting any adverse event Intravenous ketorolac vs placebo | RR 1.09 [1, 1.19] | 8 studies · 810 participants | Moderate Downgraded: risk of bias |
Number of participants experiencing a serious adverse event Intravenous ketorolac vs placebo | RR 0.62 [0.13, 3.03] | 8 studies · 703 participants | Low Downgraded: risk of bias, imprecision |
Intravenous ketorolac compared to another NSAID for adults with acute postoperative pain
Population: adults (mean study ages 23 to 67 years) with acute postoperative pain after abdominal/pelvic, dental or orthopedic surgeries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of participants with at least 50% pain relief over 4 hours Intravenous ketorolac vs another NSAID | RR 1.04 [0.89, 1.21] | 4 studies · 337 participants | Low Downgraded: risk of bias, imprecision |
Number of participants with at least 50% pain relief over 6 hours Intravenous ketorolac vs another NSAID | RR 1.06 [0.95, 1.19] | 6 studies · 603 participants | Moderate Downgraded: risk of bias |
Median time to use of rescue medication Intravenous ketorolac vs another NSAID | no estimate extracted | 4 studies · 427 participants | Low Downgraded: risk of bias, imprecision |
Number of participants using rescue medication over 4 or 6 hours post interventions Intravenous ketorolac vs another NSAID | RR 0.9 [0.58, 1.4] | 3 studies · 260 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Number of participants reporting any adverse event Intravenous ketorolac vs another NSAID | RR 1.11 [1, 1.23] | 5 studies · 516 participants | Moderate Downgraded: risk of bias |
Number of participants experiencing a serious adverse event Intravenous ketorolac vs another NSAID | RR 3.18 [0.13, 76.99] | 5 studies · 530 participants | Low Downgraded: risk of bias, imprecision |