Tolerability of ketorolac administered via continuous subcutaneous infusion for cancer pain: A preliminary report

Abstract

We evaluated the local and systemic tolerability of ketorolac administered through continuous subcutaneous infusion in ten cancer patients. The patients were monitored daily for the severity and duration of pain, and the development of other symptoms. The duration of injection site varied from 1 to more than 7 days. No patients complained of local discomfort or pain. Mild local bleeding at the site of drug injection was observed in seven cases. No increase in the intensity of symptoms was observed during the infusion of ketorolac.

Use of parecoxib by continuous subcutaneous infusion for cancer pain in a hospice population

“… 4 In our study of CSCI use, bone pain was the most frequent documented indication, involving 54/72 (75%) patients. This is in keeping with recorded use of diclofenac and ketorolac CSCI, 5–8 the other parenteral NSAIDS commonly used within palliative care. The licenced maximum daily dose of parecoxib is 80 mg.…”

“… 11 Such comparisons are challenging due to different reporting methods, with the rate for CSCI ketorolac site reactions in the literature ranging from 0% to 70%. 5–7 Simple non-drug measures such as using different giving sets or changing the administration site more frequently have been recommended to reduce site reaction incidence. 11 12 The mean total volume was 11.9 mL but, as a result of the study, our standard practice has changed.…”

The Role of Subcutaneous Ketorolac for Pain Management

“…Combined patient population of case reports (5) and observational studies (2) was small (91 patients) and included diverse pain syndromes related to cancer, including bone and neuropathic pain. 6–12 The dose and delivery method and outcome measurements were different among the studies, making data synthesis somewhat challenging. Length of therapy was extended (> 5 days) in a majority of the patients and was associated with 6 GI bleeding events, but no renal adverse events were reported.…”

“…De Conno et al 11 evaluated the local and systemic tolerability of ketorolac CSI in cancer patients who had their pain well-controlled by other therapeutic measures prior to enrollment. Ten patients participated in this study and received ketorolac CSI 90 mg over 24 hours.…”

“…[10][11][12] Of the 144 patients who received ketorolac CSI, GI bleeding occurred in 6 patients and no patient had renal dysfunction.…”