Intramuscular Ketorolac Versus Oral Ibuprofen in Acute Musculoskeletal Pain

Study objective: To evaluate the efficacy of IM ketorolac versus that of oral ibuprofen in acute musculoskeletal pain. Design: Randomized, prospective, double-blind clinical trial. Setting: Urban teaching emergency department with an annual census of 43,000. Participants: Convenience sample of 82 patients aged 18 to 70 years with acute musculoskeletal pain due to trauma. Interventions: Forty-two subjects each received 60 mg ketorolac by IM injection and ingested a placebo capsule. Forty subjects each ingested 800 mg ibuprofen and received a placebo (saline) IM injection. Pain was evaluated with a 100-mm visual analog scale at baseline and 15, 30, 45, 60, 75, 90, and 120 minutes after dosing. The prevalence of side effects was elicited in each patient. Results: Mean pain scores improved in each group during the course of the study but did not significantly differ between groups at baseline or at any subsequent interval. The numbers of dropouts due to inadequate analgesia and prevalence of side effects in the two groups did not differ significantly. Conclusion: IM ketorolac and oral ibuprofen provide comparable analgesia in ED patients with acute musculoskeletal pain. [Turturro MA, Paris PM, Seaberg DC: Intramuscular ketorolac versus oral ibuprofen in acute musculoskeletal pain. Ann Emerg Med August 1995;26:117-120.]