Use of Ketorolac in Management of Post-Operative Pain After Heart Surgery

Inclusion Criteria: Males and females > 18 years of age at the screening visit. Undergoing coronary artery bypass graft or single valve repair or replacement requiring cardiopulmonary bypass. American Society of Anesthesiology (ASA) Physical Class 3, or 4. Willing able to use a PCA Pump Willing to receive iv morphine for 24 hours post initial ketorolac dose to control pain. Capable of speaking and understanding English sufficiently to provide written informed consent and responses to pain assessment scales and neurological questionnaires. Exclusion Criteria: Allergy or sensitivity to nonsteroidal anti-inflammatory drugs History of gastrointestinal bleeding or peptic ulcer Serum creatinine = 2.0 mg/dl or rise in serum creatinine of = 0.5 mg/dl or 25% within the preceding 10 days if known with the exception of patients with Dialysis Dependent End Stage Renal Disease (ESRD). Hepatic dysfunction Patients with low cardiac output syndrome (cardiac index < 2.0) after cardiopulmonary bypass or pre-op ejection fraction < 30% Inability to operate PCA pump Cardiothoracic reoperations Bleeding disorder