J Back Musculoskelet Rehabil. 2011;24(1):31-8.
Rapid analgesic onset of intra-articular hyaluronic acid with ketorolac in osteoarthritis of the knee.
Lee SC, Rha DW, Chang WH.
Source
Department of Physical Medicine and Rehabilitation, Myongji Hospital, Kwandong University College of Medicine, Koyang, Kyunggi, Korea.
Abstract
OBJECTIVE:
The purpose of this study was to evaluate the efficacy of intra-articular ketorolac to improve intra-articular hyaluronic acid (HA) therapy in knee osteoarthritis with respect to the initiation of pain relief.
METHODS:
This study was designed as a single-blind study with a blinded observer and a 3-month follow-up. Forty-three patients with knee osteoarthritis were randomized to the ketorolac group (n=21) or the HA group (n=22). Ketorolac group members were given three weekly intra-articular injections of HA with ketorolac and then two weekly intra-articular injections of HA; and HA group members were given five weekly intra-articular HA injections. Visual analog scale (VAS), pain rating score (PRS) and adverse events were assessed at baseline and at 1st, 3rd, 5th, and 16th week after treatment commencement.
RESULTS:
Significant improvement regarding pain assessment tools was observed in the ketorolac group by the addition of ketorolac to HA as compared with the HA group within 16 weeks of follow-up (p < 0.05). In the ketorolac group, 5 of the 21 subjects developed focal post-injection knee pain for about 8 hours after injection.
CONCLUSION:
Intra-articular HA with ketorolac showed more rapid analgesic onset than intra-articular HA alone and did not induce any serious complications.
Knee Surg Sports Traumatol Arthrosc. 2004 Nov;12(6):552-5. Epub 2004 Jun 9.
Analgesic effect of intra-articular ketorolac in knee arthroscopy: comparison of morphine and bupivacaine.
Calmet J, Esteve C, Boada S, Giné J.
Source
Orthopedic Surgery Service, Hospital Universitari de Tarragona Joan XXIII, Rovira i Virgili University, Mallafré Guasch 4, 43007, Tarragona, Spain.
[email protected]
Abstract
This prospective study assessed the postoperative analgesic effect of intra-articular ketorolac, morphine, and bupivacaine during arthroscopic outpatient partial meniscectomy. Group 1 patients (n=20) received postoperative injection of 60 mg intra-articular ketorolac, group 2 patients (n=20) 10 cc intra-articular bupivacaine 0.25%, group 3 patients (n=20) 1 mg intra-articular morphine diluted in 10 cc saline, and group 4 patients (n=20, controls) only 10 cc saline. We evaluated the postoperative analgesic effect (period measured from the end of the surgery until further analgesia was demanded), the level of postoperative pain (by visual analog scale 1, 2, 3, 12, and 24 h after surgery), and the need for additional pain medication (during the first 24 h after surgery). The best analgesic effect was in patients treated with intra-articular ketorolac, and this was statistically significant in: postoperative analgesic effect and the need for additional pain medication immediately after surgery, and after 24 h. No complications were found related to the intra-articular treatment. We conclude that 60 mg intra-articular ketorolac provides better analgesic effect than 10 cc intra-articular bupivacaine 0.25% or 1 mg intra-articular morphine.
