According to a retrospective chart review, administering parenteral Ketorolac doses of 15 mg intravenous (IV) and 30 mg intramuscular (IM) could enhance healthcare practitioners' assurance in delivering effective pain relief, simultaneously lowering the likelihood of adverse incidents in the management of acute pain among elderly individuals. The study aimed to assess the safety and effectiveness of low and high-dose parenteral Ketorolac to combat acute pain.

The study included elderly emergency department patients (aged 65 years and older) who were administered parenteral Ketorolac. They were divided into two groups on the basis of the dose given: 15 mg IV or 30 mg IM, and 30 mg IV or 60 mg IM. The major endpoint was to assess the analgesic effectiveness of these Ketorolac doses by measuring the need for additional pain relief from 30 minutes to 2 hours post-administration.

The secondary objectives were to observe alterations in pain scores and the prevalence of common adverse drug events related to Ketorolac. Out of the total 312 volunteers, 260 were given Ketorolac doses of 15 mg IV or 30 mg IM, while the remaining 52 were given 30 mg IV or 60 mg IM. The major endpoint was observed in 7 out of 52 subjects (13.5%) who received Ketorolac 30 mg IV or 60 mg IM and in 17 out of 260 patients (6.5%) who were given Ketorolac 15 mg IV or 30 mg IM, with an odds ratio (OR) of 2.22.

The average alteration in pain scores was 2.9 (±3.1) for people who were given doses of 30 mg IV or 60 mg IM, and 2.8 (±2.9) for those who received were administered 15 mg IV or 30 mg IM. Both groups had a low prevalence of adverse events. Pain score reduction did not differ significantly between patients receiving 15 mg IV or 30 mg IM Ketorolac and those receiving 30 mg IV or 60 mg IM.

Compared to doses of 30 mg IV or 60 mg IM, the utilization of Ketorolac doses, either 15 mg IV or 30 mg IM, revealed no heightened necessity for rescue analgesia. Additionally, there was no notable increase in the reduction of pain scores. These findings expand the concept of a ceiling dose effect associated with Ketorolac to encompass those aged 65 years and above.