Intravenous acetaminophen and intravenous ketorolac for management of pediatric surgical pain: a literature review

AANA J. 2014 Feb;82(1):53-64.

Abstract

Pediatric surgical patients are a population at risk of inadequate pain management. The American Society of Anesthesiologists' 2012 Practice Guidelines for Acute Pain Management in the Perioperative Setting recommend a multimodal approach as the most effective way to prevent and treat pain in children. A multimodal approach entails the use of 2 or more analgesic medications that act by different mechanisms, to maximally target a variety of pain receptors and reduce the potential for side effects. One method for incorporating a multimodal approach is to augment intravenous (IV) opioids with nonopioid IV analgesics. Ketorolac and acetaminophen are the 2 nonopioid IV analgesics currently available for use in the United States. This article provides a review of the literature of IV ketorolac and IV acetaminophen regarding their pharmacology, analgesic efficacy, limitations, and practical considerations, with a focus on patients 16 years of age and younger.

Publication types

  • Review

MeSH terms

  • Acetaminophen / administration & dosage*
  • Acetaminophen / adverse effects
  • Adolescent
  • Analgesics, Non-Narcotic / administration & dosage
  • Analgesics, Non-Narcotic / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Child
  • Humans
  • Injections, Intravenous
  • Ketorolac / administration & dosage*
  • Ketorolac / adverse effects
  • Nurse Anesthetists*
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / prevention & control

Substances

  • Analgesics, Non-Narcotic
  • Anti-Inflammatory Agents, Non-Steroidal
  • Acetaminophen
  • Ketorolac