{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:08:02Z","timestamp":1783764482368,"version":"3.55.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T00:00:00Z","timestamp":1485907200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:p>Background: Previous clinical trials have demonstrated benefit with the addition of continuous infusion (CI) ketorolac to a multimodal pain regimen in surgical patients. Data following major orthopedic surgery are minimal and conflicting. Objectives: To evaluate CI ketorolac use following unilateral total knee arthroplasty (TKA) through assessment of patient-reported pain scores, opioid consumption, and safety outcomes. Methods: This was a retrospective, open-label cohort study that included patients undergoing unilateral TKA at a single-center teaching hospital. Participants were categorized into 2 study groups based on postoperative management: CI ketorolac or opioid protocol (OP). The first group received a ketorolac 30-mg bolus followed by CI 3.6 mg\/h plus as-needed (PRN) opioids. The OP group received PRN narcotics in a tiered protocol. The primary end point was comparison of median pain scores. Secondary end points included opioid consumption (morphine equivalent units [MEUs]) in the first 48 hours postoperatively, length of stay, and adverse effects. Results: Of 447 patients screened, 191 were analyzed (CI ketorolac, n = 116; OP, n = 75). Median pain scores were significantly lower in the CI ketorolac group at 48 hours postoperatively (3 [2-4] vs 3.5 [2.5-5], P = 0.033). Cumulative MEUs at 48 hours were significantly lower in the CI ketorolac group (33.9 \u00b1 38.5 mg vs 301.6 \u00b1 36.6 mg, P &lt; 0.001). Patients in the CI ketorolac group experienced less respiratory depression (5.2% vs 25.3%, P &lt; 0.001) and less naloxone administration (0% vs 8%, P = 0.002) compared with the OP group. Other adverse effects were similar among groups. Conclusions: Postoperative CI ketorolac improved pain control while reducing opioid consumption and adverse effects.<\/jats:p>","DOI":"10.1177\/1060028017694655","type":"journal-article","created":{"date-parts":[[2017,2,18]],"date-time":"2017-02-18T02:29:06Z","timestamp":1487384946000},"page":"451-456","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Continuous Infusion Ketorolac for Postoperative Analgesia Following Unilateral Total Knee Arthroplasty"],"prefix":"10.1177","volume":"51","author":[{"given":"Amy J.","family":"Schwinghammer","sequence":"first","affiliation":[{"name":"University of California Davis Medical Center, Sacramento, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex N.","family":"Isaacs","sequence":"additional","affiliation":[{"name":"Purdue University College of Pharmacy, Indianapolis, IN, USA"},{"name":"Eskenazi Health, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney W.","family":"Benner","sequence":"additional","affiliation":[{"name":"Shelbourne Knee Center, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Freeman","sequence":"additional","affiliation":[{"name":"University of Indianapolis, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob A.","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Nisly","sequence":"additional","affiliation":[{"name":"Wingate University School of Pharmacy, Wingate, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,2,1]]},"reference":[{"key":"bibr2-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/66.6.703"},{"key":"bibr3-1060028017694655","first-page":"5","volume":"33","author":"Skinner HB.","year":"2004","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"bibr4-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200811000-00002"},{"key":"bibr5-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199907000-00006"},{"key":"bibr6-1060028017694655","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1213\/00000539-199807000-00019","volume":"87","author":"Singelyn FJ","year":"1998","journal-title":"Anesth Analg"},{"key":"bibr7-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31823c1030"},{"key":"bibr8-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1223"},{"key":"bibr9-1060028017694655","doi-asserted-by":"crossref","first-page":"ES9","DOI":"10.36076\/ppj.2012\/15\/ES9","volume":"15","author":"Manchikanti L","year":"2012","journal-title":"Pain Physician"},{"key":"bibr10-1060028017694655","first-page":"1487","volume":"60","author":"Center for Disease Control and Prevention","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"11","key":"bibr11-1060028017694655","first-page":"11","volume":"42","author":"The Joint Commission","year":"2014","journal-title":"Jt Comm Perspect"},{"key":"bibr12-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(02)00691-7"},{"key":"bibr13-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.287.6398.1026"},{"key":"bibr14-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1992.tb03463.x"},{"key":"bibr15-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199202000-00006"},{"key":"bibr16-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/72.4.383"},{"key":"bibr17-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199406000-00015"},{"key":"bibr18-1060028017694655","first-page":"1175","volume":"81","author":"Etches RC","year":"1995","journal-title":"Anesth Analg"},{"key":"bibr19-1060028017694655","first-page":"116","volume":"11","author":"Shelbourne KD","year":"1998","journal-title":"Am J Knee Surg"},{"key":"bibr20-1060028017694655","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1996.tb04513.x"},{"key":"bibr21-1060028017694655","unstructured":"Fresenius Kabi USA, LLC. 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