TORADOL (ketorolac) linked to Recurrence Prevention

stephy in Forget'smstudy generic Voltaren was used and a an opiod not available in this country. Check page 10. I posted re: what was used . It's directly after the article.

Stephy, solfeo dead on right. working on something working on something bbL

Well something is seriously wrong here. Went to the article again and there is a statement. that is clearly wrong. " Importantly, no opioids were given during or after surgery" That is a direct quote from the article. But Sufentanil was used pre-incision & intraoperatively, and a drug piritramide(not available in USA--similar to a metabolite of Demerol) was used post op. Forget's statement clearly identified opiods were used.

Big error in the article, maybe that's why I didn't catch the no opiod thing before b/c I knew Sufentanil was an opiod. Well this is a mess. Hmmmmm I'm guessing all the medical people were reading the drugs and others were reading the no opiod statement.

I sent a email to Retsky. Hmm 5(6 pre publication) years.......no one caught the discrepancy. That's a worry.

Norco is hydrocodone and acteominophen ---good drug. Do you have it or does someone have to get it from the pharmacy?

Loverly, can you watch for her. I'm going to go find the pain scale I use.

Good Stephy, Well that was chit. We were working on one thing and forgot the basics. This is a post I wrote years ago.

Rainy and solfeo make sure you read.

Jun 21, 2011 01:22 am sas-schatzi wrote:

This is going to be long, sorry folks. Generic description of how to evaluate pain and what to do.

Try to see if comfort measures will change level of pain. If you have been in one position too long that can cause muscle fatigue which can lead to pain. When appropriate try warming up, mild stretching, or getting up and walk around. In the hospital, after asking what when where why , how long etc to determined what I was dealing with, I'd look to see if something to tight/ restricting etc. If the patient has pushed things too much, too fast pain could be from over use---rest. Bottom line is figure out what we are dealing with first.

Using the pain scale. Research has shown that the worst judges of a patients pain are doctors and nurses. The best judge of the patient pain is there own self description. Everyone's tolerance of pain and response to pain is different.

I know allot of people mock the pain scale, but with adequate explanation it works. The visual smiley frown face scale was developed for children. It accuracy has been proven by research. With adults the visual scale has been proven to be inaccurate. The numerical scale is the method of choice that is more accurate in adults.

Zero is no pain. 1-3 is mild pain, generally tolerated well. There are people that would like relief from this level of pain. Tylenol or NSAIDS like motrin, advil, if tolerated usually work well.

4- 6 is moderate pain. The choice of pain reliever can be individual here too. Many people do not like taking a narcotic because of fear of getting hooked. So using the previously mentioned drugs are okay. Some people don't get relief with these drugs, taking the lowest dose narcotic may be a better choice for this individual. Many of the narcotics are combined with the NSAIDS or Tylenol. For example, Tylenol 325 mg with oxycodone 5mg = percocet, tylenol 500 mg + oyxcodone = Tylox, Hydrocone and tylenol 325mg =Vicodin/Norco etc. Generally, pain prescriptions are written, for example, "Take one to two tabs as necessary for pain every 4-6 hours". I suggest try one pill at lowest dose. If relief is not acceptable, and the doc has said it's okay take the second one---do so.

7-10 is severe pain, if at home this is the range that taking the higher allowed dose versus one is a consideration. Generally, you should expect pain level to decrease below at least a four. If no pain relief call doctor, this is the time to call your doc. Please, don't exceed recommend doses without doctor being aware because it could be an indicator something serious is brewing.

NSAIDS and tylenol are not benign drugs. Taken in doses higher than recommended can cause damage to the liver and the kidney, that may not be reversible. NSAIDS and tylenol should never be taken with alcohol. Damage to the liver can be caused by mixing these drugs and alcohol.

In summary, tyr comfort measures i.e position change, massage, adequate sleep, adequate hydration. Lack of proper hydration will cause the muscles to ache/pain and fatigue faster. Use pain medicine either non-narcotic or narcotic based on pain level. If they're is no response to pain reliever or pain relief isn't acceptable call your doctor.

Edit: Recently have become aware of narcotic affect on immunity in cancer patients. Just mention it as an FYI to discuss with your doc.

LOverly, and Hopeful what are you doing up? You gals are always there when I need you.

solfeo, if they show you the smiley face pics for pain description. Those were developed for kids. Kids do remarkably accurate with them. Adults have a hard time. A. Description like I use is for adults. Your welcome