Abstract
Objective: One of nonsteroidal anti-inflammatory drugs (NSAIDs) named as ketorolac is frequently used to relieve acute pain. Current study was conducted with the aim of ketorolac efficacy measurement as a pain killer agent for controlling the primary headache in emergency departments. Methods: In this study, we enrolled 50 patients with primary headache who received 60 mg ketorolac intravenously as a slow infusion in about 10 minutes. Pain scores were evaluated with visual analog scale (VAS) on arrival and also 1 hour and 2 hours after ketorolac infusion. Statistical analysis was performed on collected data by using Wilcoxon and Mann-Whitney tests to assess the differences in VAS pain scores. Results: Decreasing the VAS more than 3 points from the arrival until 1 hour (P < 0.001), and more than 5 points from the arrival until 2 hours after ketorolac administration (P < 0.001) were seen. Those with history of analgesic use before admission in emergency department in comparison with the others did not accompany with more decline in pain score after 1 hour (P = 0.34) or 2 hours (P = 0.92). Conclusion: It seems that ketorolac is assured, safe and well tolerated agent for pain control in patients presented with primary headache to the emergency departments. Based on the results achieved in this study, ketorolac illustrates its perceptible effects within 1 hour after administration that even more prominent after 2 hours.
Highlights
Headache is an omniscient illness with a lifetime prevalence rate reaching 90% [1]
The P values related to comparison of visual analog scale (VAS) between two groups at baseline, 1 hour and 2 hours after ketorolac administration were 0.51, 0.62, and 0.69, respectively
Intravenous ketorolac was compared with nasal sumatriptan in a prospective double-blind study that performed on patients with complaint of migraine headache
Summary
Headache is an omniscient illness with a lifetime prevalence rate reaching 90% [1]. There are several types of headaches, so that 150 diagnostic headache categories have been defined. There are frequent guidelines for management of acute headaches that generally recommended several different agents, such as dihydroergotamine, triptans, phenothiazines, opioids or nonsteroidal anti-inflammatory drugs (NSAIDs) [4,5,6]. Ketorolac accepted as an alternative to non-steroidal analgesics and opioid in controlling moderate to severe pain [12]. Thinking that different types of headaches involve the same inflammatory component in their pathophysiology, ketorolac is expected to be effective. This agent is an efficient non-narcotic pain killer with intermediate anti-inflammatory effect. Current study was conducted with the aim of ketorolac efficacy measurement as a non-narcotic antiinflammatory pain killer agent for controlling the primary headache in of patients presented to the ED with all types of primary headaches
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