{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:29:26Z","timestamp":1791901766358,"version":"4.3.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[1998,2,1]],"date-time":"1998-02-01T00:00:00Z","timestamp":886291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[1998,2]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To report the case of a prolonged intravenous ketorolac continuous infusion given via a central line in a cancer patient with intractable bone pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARY:<\/jats:title>\n                    <jats:p>A 56-year-old Hispanic man with stage IV non-small-cell lung cancer and multiple bone metastases was admitted to the hospital for intractable pain inadequately controlled at home by conventional therapy. He was treated with an intravenous continuous infusion of ketorolac 120 mg in 250 mL of NaCl 0.9% infused over 24 hours. The ketorolac was given via a central line for 14 days in addition to fentanyl patient-controlled analgesia. Over this time period the patient reported his pain to be well controlled. His requests for bolus doses of fentanyl decreased dramatically and the dose of the continuous intravenous fentanyl was reduced by 22%. In addition, the total daily dose of ketorolac was reduced following a change from intermittent bolus dosing to a continuous infusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>The management of cancer pain secondary to bone metastasis is a difficult and challenging problem frequently encountered by the healthcare team. The use of nonsteroidal antiinflammatory drugs (NSAIDs) as adjuvant therapy is a common practice. However, many terminally ill patients are unable to take oral medications, thus limiting NSAID treatment options. Ketorolac tromethamine is approved by the Food and Drug Administration (FDA) as a parenteral NSAID. As with other NSAIDs, the risk of adverse drug reactions must be considered when using this class of medication. The FDA has approved ketorolac for the short-term (=5 d) management of moderately severe acute pain that requires analgesia at the opioid level, usually in the postoperative setting. However, certain patients may benefit from long-term use exceeding the FDA-recommended guidelines of 5 days of maximum therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>A prolonged central intravenous ketorolac continuous infusion was successful in treating a cancer patient with intractable bone pain secondary to widely metastatic non-small-cell lung cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJETIVO:<\/jats:title>\n                    <jats:p>Informar el caso de un paciente de c\u00e1ncer con dolor en los huesos a quien se le administr\u00f3 una infusi\u00f3n continua de ketorolac intravenoso mediante una linea central.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESUMEN DEL CASO:<\/jats:title>\n                    <jats:p>Un paciente de 56 a\u00f1os del g\u00e9nero masculino con un diagn\u00f3stico de c\u00e1ncer del pulm\u00f3n de c\u00e9lula no peque\u00f1a en etapa con m\u00faltiples met\u00e1stasis a hueso fue admitido al hospital con dolor inadecuadamente controlado con terapia convencional. Fue tratado con una infusi\u00f3n continua de 24 horas de ketorolac 120 mg en 250 mL de cloruro de sodio es 0.9%. El ketorolac se administr\u00f3 mediante una l\u00ednea central durante un total de 14 d\u00edas. El paciente recib\u00eda fentanilo por la v\u00eda parenteral. El paciente inform\u00f3 que su dolor estuvo bien controlado durante ese tiempo. Sus pedidos de fentanilo disminuyeron dram\u00e1ticamente y la dosis de este f\u00e1rmaco fue reducida por un 22%. La dosis total de ketorolac se redujo luego de cambiar de bolos intermitentes de fentanilo a una infusi\u00f3n continua.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSI\u00d3N:<\/jats:title>\n                    <jats:p>El manejo de dolor de c\u00e1ncer debido a met\u00e1stasis en hueso es un problema frecuente y dificil de resolver. El uso de antiinflamatorios no esteroidales como adyuvante es de practica com\u00fan. Sin embargo, los pacientes terminales con frecuencia no pueden tomar medicamentos orales, limitando las opciones de tratamiento con antiinflamatorios no esteroidales. Ketorolac es un antiinflamatorio no esteroidal parenteral aprobado por la Administraci\u00f3n de Drogas y Alimentos (ADA). Al igual que con otros antiinflamatorios no esteroidales, se debe considerar el riesgo de reacciones adversas cuando se utilizan esta clase de medicamentos. La ADA ha aprobado al ketorolac para el manejo de dolor agudo moderado a severo (\u22645 d\u00edas) usualmente en el escenario post operatorio. Sin embargo, algunos pacientes pueden beneficiarse del uso prolongado de ketorolac y exceder las gu\u00edas de un m\u00e1ximo de 5 d\u00edas recomendadas por ADA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONES:<\/jats:title>\n                    <jats:p>Se informa un caso de un paciente con c\u00e1ncer con dolor \u00f3seo secundario a met\u00e1stasis de c\u00e1ncer del pulm\u00f3n de c\u00e9lula no peque\u00f1a que fue exit\u00f3samente manejado con una infusi\u00f3n continua de ketorolac.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIF:<\/jats:title>\n                    <jats:p>Rapporter le cas d'une perfusion intraveineuse prolong\u00e9e de k\u00e9torolac administr\u00e9e par voie centrale chez un patient canc\u00e9reux avec douleur osseuse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>R\u00c9SUM\u00c9 DE CAS:<\/jats:title>\n                    <jats:p>Un homme de 56 ans atteint d'un cancer pulmonaire non \u00e0 petites cellules de stade IV et pr\u00e9sentant de nombreuses m\u00e9tastases osseuses est admis pour douleur intol\u00e9rable et ajustement de celle-ci. Durant son hospitalisation, le patient a re\u00e7u une perfusion intraveineuse continue sur 24 heures de 120 mg de k\u00e9torolac dans 250 mL de chlorure de sodium 0.9%. Le k\u00e9torolac a \u00e9t\u00e9 administr\u00e9 par voie centrale pour un total de 14 jours en plus d'une analg\u00e9sie contr\u00f4l\u00e9e par le patient au fentanyl. Durant cette p\u00e9riode, la douleur du patient a \u00e9t\u00e9 bien contr\u00f4l\u00e9e. Ses besoins en bolus de fentanyl ont diminu\u00e9 dramatiquement et la dose du fentanyl continu a \u00e9t\u00e9 r\u00e9duite de 22%. De plus, la dose totale quotidienne de k\u00e9torolac a pu \u00eatre diminu\u00e9e suite au passage de l'administration intermittente bolus \u00e0 la perfusion continue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>Le soulagement de la douleur canc\u00e9reuse caus\u00e9e par les m\u00e9tastases osseuses repr\u00e9sente un probl\u00e8me souvent rencontr\u00e9 dans notre syst\u00e8me de sant\u00e9. Les anti-inflammatoires non st\u00e9ro\u00efdiens (AINSs) sont fr\u00e9quemment utilis\u00e9s comme co-analg\u00e9siques. Cependant, de nombreux malades en phase terminale sont incapables de prendre une m\u00e9dication orale, limitant ainsi l'utilisation des AINSs. Le k\u00e9torolac tromethamine est un AINS parent\u00e9ral approuv\u00e9 par l'Administration des Drogues et Aliments (ADA). Comme avec les autres agents de cette classe, le clinicien doit tenir compte du risque d'effets secondares en employant ces m\u00e9dicaments. Il faut se rappeler que l'ADA a approuv\u00e9 l'utilisation du k\u00e9torolac pour le soulagement \u00e0 court terme (\u22645 jours) de la douleur aigu\u00eb mod\u00e9r\u00e9e \u00e0 s\u00e9v\u00e8re post-op\u00e9ratoire n\u00e9cessitant habituellement l'usage d'un narcotique analg\u00e9sique. Cependant, certains patients peuvent b\u00e9n\u00e9ficier d'un usage prolong\u00e9 exc\u00e9dant les recommandations d'un maximum de 5 jours \u00e9mises par l'ADA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.17205","type":"journal-article","created":{"date-parts":[[2004,3,11]],"date-time":"2004-03-11T17:08:19Z","timestamp":1079024899000},"page":"193-196","source":"Crossref","is-referenced-by-count":15,"title":["Prolonged Central Intravenous Ketorolac Continuous Infusion in a Cancer Patient with Intractable Bone Pain"],"prefix":"10.1177","volume":"32","author":[{"given":"Richard L","family":"Gordon","sequence":"first","affiliation":[{"name":"Richard L Gordon PharmD, at time of writing, Adjunct Professor, School of Pharmacy, University of the Pacific, and Geriatric Clinical Pharmacy Specialist, Veterans Affairs Medical Center, San Diego, CA; now, Ambulatory Care Pharmacy Specialist, Kaiser Permanente, 10992 San Diego Mission Rd., San Diego, CA 92108, FAX 619\/641-4260"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1998,2,1]]},"reference":[{"key":"bibr1-aph.17205","volume-title":"Product monograph. 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