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Department of Paediatric Anaesthesia, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada
To the Editor:
Pappas et al. (1) showed convincingly that a single dose of ketorolac 1 mg/kg given intramuscularly provides better pain relief after myringotomy than conventional treatments such as acetaminophen, acetaminophen with codeine, or the novel approach of intranasal butorphanol. Although they avoided the IV route of drug administration, I propose an alternative that is simple, effective and time efficient. By asking an assistant to squeeze the forearm gently and act as a tourniquet, one can easily cannulate a vein in most children using a fine 25-g or even 27-g butterfly cannula and give a single bolus of ketorolac 0.5 mg/kg. This is in keeping with the recent findings of Dsida et al. (2), who reported on the pharmacokinetics of IV ketorolac in children and found this smaller dose of 0.5 mg/kg sufficient to provide prompt and long-lasting pain relief.
Footnotes
Dr. Pappas does not wish to respond.
References
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