Utilization of Ketorolac for Pain Control During Nephrostomy and Nephroureteral Stent Exchange: A Quality Improvement Study

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Rash, Wendy
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Research Subject Categories::INTERDISCIPLINARY RESEARCH AREAS::Caring sciences::Nursing , Opioid , Pain , Nephrostomy , Nephroureteral , Sedation , Ketorolac
Patients with nephrostomy/nephroureteral stents undergo exchange procedures every six to eight weeks to maintain patency. This procedure is commonly performed with moderate sedation using opioid medications. These medications are not without risks relating to maintenance of airway and rate of breathing. A quality improvement study was conducted to evaluate the effectiveness of adding ketorolac to a reduced amount of opioid administration during this procedure to examine pain scores. Pain scores were measured by the Visual Analogue Scale during the pre procedure, during procedure and post procedure periods. Ketorolac has shown to be effective in other areas of pain management but there was a gap in research related to this procedure. Six of the ten patients required half of the previous total of opioids. Four of the ten patients received the full dose of opioids. There were no significant differences between these groups in pre procedure pain score or the post procedure pain score. The patients receiving half the dose of opioids were able to achieve similar pain control compared to those patients receiving the full dose.