Abstract

Objective: We evaluated the effect of ketorolac on reducing the severity of acute pancreatitis.Design: Randomized clinical trial.Setting: University hospital.Participants: Fifty six adult patients, with predicted severe acute pancreatitis, were randomly divided into two groups.Methods: The patients in the study group received intravenous ketorolac, 10 mg, three times daily from the time of enrollment for a maximum of five days as needed along with standard medical treatment. Primary outcome measure was the change in the serum level of high sensitive c reactive protein (hs-CRP). Patients were also followed up in terms of hospitalization duration, need for ICU, development of organ failure, persistent organ failure, pancreatic necrosis, nutritional assessment, and mortality. The study was continued to gather clinical follow up information up to four months.Results: Serum level of hs-CRP was significantly lower in the ketorolac group compared with the control group on days 3, 4, and 5. There was no significant difference in organ failure, pseudocyst formation, acute necrotic collection, mortality and ICU transfer between two groups. Days of hospitalization were significantly lower in the study group. The feeding start time was significantly shorter in the study group with no need for tube feeding in the ketorolac group. Frequency of NPO (not per oral) was significantly lower in the ketorolac group.Conclusion: The use of ketorolac may improve feeding outcomes and shorten length of hospitalization in predicted severe acute pancreatitis.