Ketorolac tromethamine - routes and clinical implications

Pain Pract. 2015 Feb;15(2):175-93. doi: 10.1111/papr.12198. Epub 2014 Apr 16.


Opioids have long been used for analgesic purposes for a wide range of procedures. However, the binding of these drugs to opiate receptors has created various challenges to the clinician due to unfavorable side effect profiles and the potential for tolerance and abuse. In 1989, ketorolac became an approved nonsteroidal inflammatory drug (NSAID) for injectable use as an analgesic. Over the last 20 years, numerous studies have been conducted involving ketorolac. These studies have provided additional information about various routes of administration and their effect on the efficacy and the side effect profile of ketorolac. Moreover, ketorolac has been compared with several widely used analgesics. This review evaluates both the potential benefits and potential drawbacks of ketorolac generally, and specifically discusses routes of administration, including their advantages and disadvantages when compared to several traditional analgesics in both inpatient and outpatient settings.

Keywords: analgesia; analgesic, nonopioid; ketorolac; postoperative pain; review; route of administration.

Publication types

  • Review

MeSH terms

  • Administration, Intranasal
  • Administration, Intravenous
  • Administration, Oral
  • Analgesics / therapeutic use
  • Analgesics, Opioid / therapeutic use
  • Anesthetics, Local / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Drug Therapy, Combination
  • Gastrointestinal Hemorrhage / chemically induced
  • Humans
  • Injections, Intramuscular
  • Ketorolac Tromethamine / administration & dosage*
  • Ketorolac Tromethamine / therapeutic use
  • Nerve Block
  • Pain, Postoperative / drug therapy*
  • Treatment Outcome


  • Analgesics
  • Analgesics, Opioid
  • Anesthetics, Local
  • Anti-Inflammatory Agents, Non-Steroidal
  • Ketorolac Tromethamine