To compare the
analgesic efficacy and tolerability of intravenous (IV)
ketorolac tromethamine with IV
meperidine in the treatment of biliary
colic, a prospective, randomized, double blind study was carried out upon a convenience sample of patients at a large inner city facility. Patients between the ages of 18 and 65 years of age with a history and physical examination consistent with biliary
colic were enrolled over a 2-year period. Patients were randomly assigned to receive
ketorolac 30 mg IV or
meperidine 50 mg IV.
Pain was quantified using a 4-point verbal rating system (VRS) as well as a visual analog scale (VAS). Patients were queried about their
pain at times 0, 12 h, 1 h, and 2 h after administration of the study medication. Adverse effects were also recorded. A total of 324 patients completed the study protocol with 175 patients receiving
ketorolac and 149 receiving
meperidine. Patient demographics were similar for both groups with mean age for the
ketorolac group of 36.1 years and for the
meperidine group of 34.6 years. Both groups were predominantly Latino and over 80% of patients in both groups were female. No significant difference in
pain control was found between
ketorolac and
meperidine in either the VAS or VRS for any time interval studied. The mean change in the VAS at time 2 h was 6.2 cm +/- 3.6 cm for the
ketorolac group, compared with 6.7 cm +/- 3.6 cm for the
meperidine group (p = 0.25). Although no significant difference was found in overall
drug tolerability, patients receiving
meperidine reported higher incidences of
nausea and of
dizziness than those receiving
ketorolac (p = 0.009 and 0.003, respectively).
Ketorolac tromethamine is a well-tolerated, effective medication in the treatment of acute biliary
colic. It showed similar efficacy to
meperidine with a decreased number of adverse effects.