Research Symposium Program - Individual Details

Optimizing Ketorolac Utilization in Anesthesia Practice: Implementing the Analgesic Ceiling Dose

Abstract

Effective pain management is crucial in healthcare, and intravenous (IV) ketorolac is commonly used to achieve analgesia. Though multiple studies have shown the analgesic ceiling dose of ketorolac to be 10 mg IV, greater doses are often administered in clinical practice. This quality improvement project aimed to educate Certified Registered Nurse Anesthetists (CRNAs) on the analgesic ceiling effect of ketorolac IV and encourage the use of 10 mg doses. Pre-intervention and post-intervention data (ketorolac administration) were collected over 30 days. A one-week educational intervention was implemented between these two periods for CRNAs. There was a significant increase in the use of the 10 mg post-intervention (from 0.00% to 54.55%), and a corresponding decrease in the use of the 30 mg post-intervention (from 82.76% to 27.27%). There was a minimal change in the use of 15 mg doses. The most significant change was the increase in 10 mg doses, suggesting that the educational intervention effectively influenced ketorolac administration practices. The educational intervention effectively influenced nurse anesthetists dosing practices. However, limitations such as staff turnover and reliance on a single educational method were identified. Future research could explore alternative educational strategies to enhance knowledge retention and behavior change. Sustaining the 10 mg ketorolac dosage requires ongoing education and collaboration with pharmacy and surgical staff.

Keywords: ketorolac, Toradol, ceiling effect, ceiling dose