Abstract
Objective: Pain is usually one of the most common symptoms among all traumatic injuries. One of the drugs that has recently entered the Iranian prehospital emergency system is ketorolac. Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that inhibits prostaglandin synthesis by inhibiting cyclooxygenase activity and reduces pain and inflammation. It can be considered as the strongest analgesic drug in this category. The aim of this study was to evaluate the effectiveness of ketorolac in pain management of traumatic injuries in a prehospital setting. Methods: This descriptive cross-sectional study was undertaken to evaluate the effectiveness of a treatment method in the pain management of traumatic injuries in the prehospital environment of Lorestan province in Iran. We included 134 injured patients from road emergency bases of Lorestan province. In order to control the pain of these injured patients, 30 mg of ketorolac was injected slowly intravenously in one minute. Pain was measured in the time interval of zero minutes (before injection), 15 minutes, 30 minutes, and 45 minutes by visual acuity scale (VAS). The analysis of the obtained data was performed by SPSS software version 23. Results: The mean age of participants was 37.42±23.6. There were 47 female injuries (35.1%) and 87 male injuries (64.9%). In terms of pain intensity, 49 patients (36.6%) had moderate pain (VAS=4-6) and 85 patients (63.4%) had severe pain (VAS=7-10). The average of pain relief in the injured group with severe and moderate pain 15 minutes after the injection was 0.471 and 0.878 (P=0.001), respectively. In addition, the mean of pain relief in the injured group with severe and moderate pain 30 minutes after the injection was 1.124 and 1.796, respectively (P=0.001). Pain reduction in the group of severely injured patients with moderate pain in the first 30 minutes was statistically significant. Conclusion: Findings revealed that ketorolac is a suitable drug in pain management for trauma patients with moderate and severe pain in trauma patients. On the other hand, due to the peak effect (more than 30 minutes), it is not an effective drug for trauma patients with severe pain in a short period transferred to the prehospital environment.
Highlights
Trauma injuries have been on the rise in recent years, in developed countries but around the world [1]
This is followed by respiratory arrest due to suppression of the respiratory system, or long-term use such as drug dependency on the patient [5]
This descriptive study was conducted to evaluate the efficacy of ketorolac in the pain management of trauma patients in the Road Emergency Bases (REB) of Lorestan Emergency Medical Center between 2018 and 2019
Summary
Trauma injuries have been on the rise in recent years, in developed countries but around the world [1]. One of the most common methods of pain management for patients is the use of strong opioid analgesics, but the use of this group of drugs can cause common side effects even in short-term use, such as nausea and dizziness and respiratory rhythm disorders. This is followed by respiratory arrest due to suppression of the respiratory system, or long-term use such as drug dependency on the patient [5]. Being an analgesic is one of the most common uses of ketorolac It can be considered as the strongest analgesic in this class of drugs [7]. The present study was conducted to evaluate the effectiveness of ketorolac injections in controlling the pain of traumatic patients in a prehospital setting
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