{"title":"Efficacy and adverse effects of lower doses of ketorolac; a systematic review and meta-analysis.","authors":"Maryam Bahreini, Heewa Rashnavandi, Fatemeh Rasooli, Alireza Jalali, Rasoul Masoumi, Hadi Mirfazaelian","doi":"10.1080/17581869.2025.2560293","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Ketorolac, a non-steroidal anti-inflammatory drug, is proposed to have a ceiling effect. We studied if ketorolac at lower doses was as effective and safe as the standard doses.</p><p><strong>Area covered: </strong>Randomized trials on different doses of ketorolac were searched in MEDLINE, Embase, Scopus, and Web of Science from the inception date to 12 December 2024. The extent of change in pain, pain relief, need for rescue analgesia, reduction in patient opioid consumption, and adverse event rates were outcomes of interest. The risk of bias was assessed using the Cochrane Risk of Bias tool version 2.</p><p><strong>Expert opinion/commentary: </strong>In acute, postoperative, and cancer pain, there was no difference in the analgesic effect of lower doses of ketorolac in comparison to routine doses. In addition, the results did not show higher adverse effects.</p><p><strong>Protocol registration: </strong>www.crd.york.ac.uk/prospero identifier is CRD42023480153.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"733-744"},"PeriodicalIF":1.5000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pain management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/17581869.2025.2560293","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/16 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Ketorolac, a non-steroidal anti-inflammatory drug, is proposed to have a ceiling effect. We studied if ketorolac at lower doses was as effective and safe as the standard doses.
Area covered: Randomized trials on different doses of ketorolac were searched in MEDLINE, Embase, Scopus, and Web of Science from the inception date to 12 December 2024. The extent of change in pain, pain relief, need for rescue analgesia, reduction in patient opioid consumption, and adverse event rates were outcomes of interest. The risk of bias was assessed using the Cochrane Risk of Bias tool version 2.
Expert opinion/commentary: In acute, postoperative, and cancer pain, there was no difference in the analgesic effect of lower doses of ketorolac in comparison to routine doses. In addition, the results did not show higher adverse effects.
Protocol registration: www.crd.york.ac.uk/prospero identifier is CRD42023480153.
酮咯酸是一种非甾体抗炎药，被认为有上限效应。我们研究了低剂量的酮咯酸是否和标准剂量一样有效和安全。涵盖领域：检索MEDLINE、Embase、Scopus和Web of Science中从开始日期到2024年12月12日的不同剂量酮罗拉酸的随机试验。疼痛变化的程度、疼痛缓解、需要抢救性镇痛、减少患者阿片类药物的消耗和不良事件发生率是我们感兴趣的结果。使用Cochrane风险偏倚工具第2版评估偏倚风险。专家意见/评论：在急性、术后和癌性疼痛中，与常规剂量相比，低剂量酮罗拉酸的镇痛效果没有差异。此外，结果没有显示出更高的不良反应。协议注册：www.crd.york.ac.uk/prospero标识为CRD42023480153。
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