Comparison of Ketorolac and Fentanyl in the prehospital environment

Ketorolac emerges as a safe and effective alternative to Fentanyl in prehospital settings, advocating for the adoption of opioid-sparing treatment strategies to address pain management needs.

To distinguish between the efficacy and safety of Ketorolac to Fentanyl in the prehospital setting and determine the potential of Ketorolac as a practical substitute analgesic (pain-killer).

We conducted a review of patient records from a New Mexico-based prehospital emergency medical services agency. The safety and effectiveness of Ketorolac with Fentanyl in prehospital care were compared.

The study evaluated various factors including medication complications, initial and final pain levels, and pain relief based on a Numerical Rating Scale. The unadjusted and adjusted (Patient age, gender, and weight) models were used to analyze the data.

We analyzed a total of 4,102 records, comprising 3,182 cases involving Fentanyl and 920 cases involving Ketorolac. No marked differences were observed in the initial and final pain levels or pain relief between the two groups. However, the adjusted models revealed a notable distinction in the occurrence of complications, with all instances happening within the Fentanyl group (64 occurrences, P<0.0001), with nausea and hypoxia being the most common ones.

Compared to Fentanyl, Ketorolac is effective and safe in the prehospital setting.