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Date of Award


Document Type

Thesis - Pacific Access Restricted

Degree Name

Master of Science (M.S.)


Pharmacy Practice

First Advisor

Robert Supernaw

First Committee Member

Linda Norton

Second Committee Member

Mary Ferrill

Third Committee Member

Xiaoling Li


A randomized, prospective, parallel, double-blind, double-dummy clinical trial was conducted to determine the analgesic efficacy and time to onset of analgesia following intravenous and intramuscular administration of ketorolac (15 and 30 mg), and oral ibuprofen 800 mg. A random sample of 100 patients aged 18 to 65, with acute musculoskeletal pain, were enrolled from the University of California Davis Medical Center, Emergency Department.

Patients were categorized into five equal groups and received, either ketorolac 30 mg (IV or IM), ketorolac 15 mg (IV or IM) or ibuprofen 800 mg (PO) tablet as medication medication. Pain intensity was evaluated with a 100-mm visual analog scale at baseline and 5, 10, 15, 30, 45, 60, 120, 180, and 240 minutes after dosing. A verbal rating scale, consisting of five rankings was also used to evaluate pain intensity and pain relief.

The time to onset of analgesia was defined as the time at which pain intensity score reached 25% and 50% of the baseline score in 25% and 50% of the patients. The prevalence of side effects was elicited in each patient.

Patients who received ketorolac (30 mg IV) showed a greater decrease in pain intensity compared with patients in all other groups (p < 0.005). Ketorolac (30 mg IV) provided greater pain relief compared with patients receiving ketorolac (15 mg IV), ketorolac (15 mg IM) or ibuprofen 800 mg (p < 0.011). Fifty percent pain relief before the end of the study was achieved by 50% of patients in one group only- ketorolac (30 rng IV). Ketorolac (30 mg IV) was found to have a quicker time to onset of action compared to ibuprofen 800 mg (p = 0.025) and ketorolac (15 mg IV) (p < 0.001). When the criterion of 25% pain relief for 25% of the patients was used, ketorolac (30 mg IV) was found to have a quicker time to onset of action compared with all other groups (p < 0.025).

Thus, ketorolac (30 mg IV) provided a greater degree of pain relief and a quicker time to onset of analgesia than all other groups, presenting with acute musculoskeletal pain. Ketorolac (30 mg IM), ketorolac (15 mg IM), ketorolac (15 mg IV) and ibuprofen 800 mg provided comparable analgesia.



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