Intravenous Ketorolac Versus Morphine in Children Presenting With Acute Abdominal Pain and Suspected Appendicitis: A Multi-centre Non-Inferiority Randomized Controlled Trial

What this Trial Is About

Researchers are studying children aged 6 to 17 who come to the emergency department with belly pain suspected to be appendicitis, a common condition requiring surgery. This study aims to compare the pain relief effects of intravenous ketorolac, a non-opioid anti-inflammatory drug, with intravenous morphine, a commonly used opioid. The goal is to see if ketorolac works as well as morphine but with fewer side effects, addressing concerns from the opioid crisis. Participants will be randomly assigned to receive either a single dose of intravenous ketorolac at 0.5 mg/kg (up to 30 mg) or intravenous morphine at 0.1 mg/kg (up to 5 mg). Both treatments are given once, with a matching placebo for the other drug to keep the study blinded. The study is conducted across multiple pediatric emergency departments in Canada, and neither patients nor most medical staff will know which treatment the child receives. During the study, children’s pain will be measured using a verbal numerical rating scale at multiple times after medication administration, including 30, 60, 90, 120 minutes, and up to 6-8 hours. Researchers will also monitor for side effects and the need for additional pain relief. Safety and effectiveness will be carefully assessed, with particular focus on pain reduction and adverse events. The total study participation involves these assessments around the time of treatment.

Intravenous Ketorolac Vs. Morphine In Children With Acute Abdominal Pain