Ketorolac intranasal offers an advantage of self-administration by patients compared to previously available intravenous and intramuscular routes of administration.There is no significant difference between intranasal ketorolac and 1000 mg acetaminophen/600 mg ibuprofen combination for untreated endodontic patients suffering from moderate to severe pain and symptomatic apical periodontitis, as explained in a randomized, double-blind investigation study published in 'Journal of Endodontics'.

Kathryn Watts et al. compared the efficacy of intranasal ketorolac with a combination of ibuprofen/acetaminophen for pain management in untreated endodontic and symptomatic apical periodontitis patients.A total of 70 patients experiencing moderate to severe pain, a pulpal diagnosis of symptomatic irreversible pulpitis or necrosis, and periapical diagnosis of symptomatic apical periodontitis participated in this study. The patients were randomly divided into two groups to receive either intranasal ketorolac 31.5 mg and placebo capsules or acetaminophen 1000 mg/ ibuprofen 600 mg capsules and a mock nasal spray. Patients recorded perceived pain scores using a visual analog scale (VAS) every 15 minutes from drug administration up to 4 hours. Time to almost 50% pain relief, the first sign of pain relief, and meaningful pain relief were noted, and data was investigated.There was a decline in reported pain until 2 hours after dosing, and after that, the reported pain remained relatively constant. No significant difference was observed between the two groups for the time to 50% pain relief, the first sign of pain relief, or meaningful pain relief.

The study authors concluded that "Intranasal ketorolac provides a non-narcotic alternative and an additional route of medication administration to the practising clinicians."