Self-administration of parenteral ketorolac tromethamine for head pain.
Sixty-one separate self-injections of ketorolac tromethamine (Toradol) by 16 patients diagnosed with episodic migraine with or without aura were evaluated over a 90-day period for safety, efficacy of pain reduction, and the ability of this therapy program to prevent the necessitation of emergency room acute care. Prior to initiation of treatment, patients were formally instructed on intramuscular injection techniques by a member of our nursing staff. Patients were instructed to call upon the onset of a severe headache interfering with daily functioning and, then, were permitted to proceed with the injection. Headache intensity ratings were collected prior to injection and intermittently for the following twenty-four hours. The results demonstrate safety and efficacy of this form of therapy. A significant percent of ketorolac usages (64%) resulted in a good response and significant reduction in head pain. Twenty-three percent of ketorolac usages resulted in a mild response and only 13% of usages provided no relief. Furthermore, 13% of all usages failed to prevent the necessitation for emergency room treatment. The results are discussed in terms of the impact of self-injection on pain relief and substantial cost-reduction by decreasing emergency room utilization.