Trial reportBMJ (Clinical research ed.)2000
Cost effectiveness analysis of intravenous ketorolac and morphine for treating pain after limb injury: double blind randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 5 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Ketorolac analgesia in the emergency department in adults: a systematic review and meta-analysis.Clinical and experimental emergency medicine · 2026Pooled it
- Pooled it
- Prophylactic antiemetics for adults receiving intravenous opioids in the acute care setting.The Cochrane database of systematic reviews · 2022Pooled it
- Adverse events associated with single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews.The Cochrane database of systematic reviews · 2015Pooled it
- Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic.BMJ (Clinical research ed.) · 2004Pooled it
- A randomized controlled trial of an ambulatory approach versus the hospital-based approach in managing suspected obstructive sleep apnea syndrome.Scientific reports · 2017Trial
- Oral administration of morphine versus ibuprofen to manage postfracture pain in children: a randomized trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2014Trial
- A comparative study of the analgesic effects of intravenous ketorolac, paracetamol, and morphine in patients undergoing video-assisted thoracoscopic surgery: A double-blind, active-controlled, randomized clinical trial.Annals of cardiac anaesthesiaTrial
- Article
- Is fascia iliaca compartment block administered by paramedics for suspected hip fracture acceptable to patients? A qualitative study.BMJ open · 2019Article
- Rapid Analgesia for Prehospital hip Disruption (RAPID): findings from a randomised feasibility study.Pilot and feasibility studies · 2019Article
- Anesthetic efficacy of ketamine, ketamine-tramadol and ketamine-ketorolac in chicks.Iranian journal of veterinary research · 2019Article
- Administration of intravenous morphine for acute pain in the emergency department inflicts an economic burden in Europe.Drugs in context · 2018Article
- Efficacy and Safety of Combination Therapy with Ketorolac and Morphine in Patient with Acute Renal Colic; A Triple-Blind Randomized Controlled Clinical Trial.Bulletin of emergency and trauma · 2017Article
- A Comparison of 4 Analgesic Regimens for Acute Postoperative Pain Control in Breast Augmentation Patients.Annals of plastic surgery · 2017Article
- The Role of Local Bupivacaine Irrigation in Postoperative Pain Control After Augmentation Mammoplasty: A Systematic Review and Meta-Analysis.Plastic surgery (Oakville, Ont.) · 2017Article
- Effect of Intravenous Morphine and Ketorolac on Pain Control in Long Bones Fractures.Advanced biomedical research · 2017Article
- Rapid analgesia for prehospital hip disruption (RAPID): protocol for feasibility study of randomised controlled trial.Pilot and feasibility studies · 2017Article
- Effect of Intravenous Ketorolac on Postoperative Pain in Mandibular Fracture Surgery; A Randomized, Double-Blind, Placebo-Controlled Trial.Bulletin of emergency and trauma · 2017Article
- Double-blind, randomized, double-dummy clinical trial comparing the efficacy of ketorolac trometamol and naproxen for acute low back pain.Drug design, development and therapy · 2016Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate the cost effectiveness of intravenous ketorolac compared with intravenous morphine in relieving pain after blunt limb injury in an accident and emergency department.
designDouble blind, randomised, controlled study and cost consequences analysis.
settingEmergency department of a university hospital in the New Territories of Hong Kong.
participants148 adult patients with painful isolated limb injuries (limb injuries without other injuries).
main outcome measuresPrimary outcome measure was a cost consequences analysis comparing the use of ketorolac with morphine; secondary outcome measures were pain relief at rest and with limb movement, adverse events, patients' satisfaction, and time spent in the emergency department.
resultsNo difference was found in the median time taken to achieve pain relief at rest between the group receiving ketorolac and the group receiving morphine, but with movement the median reduction in pain score in the ketorolac group was 1.09 per hour (95% confidence interval 1.05 to 2.02) compared with 0.87 (0.84 to 1.06) in the morphine group (P=0.003). The odds of experiencing adverse events was 144.2 (41.5 to 501.6) times more likely with morphine than with ketorolac. The median time from the initial delivery of analgesia to the participant leaving the department was 20 (4.0 to 39.0) minutes shorter in the ketorolac group than in the morphine group (P=0.02). The mean cost per person was $HK44 ( pound4; $5.6) in the ketorolac group and $HK229 in the morphine group (P<0.0001). The median score for patients' satisfaction was 6.0 for ketorolac and 5.0 for morphine (P<0.0001).
conclusionIntravenous ketorolac is a more cost effective analgesic than intravenous morphine in the management of isolated limb injury in an emergency department in Hong Kong, and its use may be considered as the dominant strategy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.