2017 Research Grant: Intravenous ketorolac substantially reduces opioid use following lumbar spinal fusion: early results of a randomized, double-blinded, placebo controlled trial

• Published in: The spine journal 2019-09, Vol.19 (9), p.S134-S134
• Main Authors: Iyer, Sravisht, Zgonis, Evangelia M., Steinhaus, Michael E, Varghese, Jeffrey J., Stein, Dan, Yang, Jingyan, Albert, Todd J., Schwab, Frank J., Lebl, Darren R, Kim, Han Jo, Cunningham, Matthew E., Farmer, James C., Girardi, Federico P., Huang, Russel C., Qureshi, Sheeraz, Rawlins, Bernard A., Beckman, James D., Sandhu, Harvinder S.
• Format: Article
• Language: English
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2019.05.290

Lumbar spine fusions are rated among the most painful surgical procedures. Adequately controlling postoperative pain while minimizing opioid use is an important public health objective. Early results of this double-blind, randomized, placebo-controlled trial show that intravenous ketorolac (IV-K) results in a substantial reduction in opioid use and improved pain control compared to placebo (IV-P) and IV acetaminophen (IV-A). IV-K did not increase rates of hematoma, drain output, transfusions or serum creatinine. There was a trend toward decreased length of stay (LOS) with IV-K. IV-K would decrease in hospital opioid use compared to IV Placebo (IV-P) and Intravenous Acetaminophen (IV-A). Randomized, double-blind trial. Patients (Pts) were randomized to receive IV-K, IV-P or IV-A. The inclusion criteria were: age 18-75, 1-2 level lumbar fusion and no history of long-term opioid use. Smokers and pts with contraindications to IV-A or IV-K were excluded. IV-K pts received 15mg (age >65) or 30mg (age 40% vs IV-P, >30% vs IV-A) and improved pain control on POD1. There is a trend toward decreased LOS; there appears to be no increase in in-hospital complications. Longer term follow-up will assess impact of IV-K on pseudarthrosis. IV-