研究目的:本次試驗之目的是比較靜脈注射30毫克ketorolac與0.1毫克fentanyl於震波碎石術中之止痛效果及其副作用。材料與方法:自1999年6月至12月，總計172位病人（108位男性，42位女性）進入試驗，其中79位為fentanyl組，73位為ketorolac組。試驗之方法是病人在接受治療5, 15, 30分鐘時以口述量表（VRS）目視量表（VAS）評估其疼痛之程度並量化之，同時記錄其副作用。結果:於每一測試點，從口述量表（VRS）目視量表（VAS）分析顯示，fentanyl組之病人均有較ketorolac組之病獲致較佳之疼痛緩解（p<0.05）。此外，ketorolac組中有21位病人（28.8%）仍必須接受50毫克之pethidine靜脈注射，疼痛方得以緩解; 而fentanyl組中僅有8位病人（10.1%）有此需要。兩者之差異有統計學上之意義（p<0.05）。結論:本試驗顯示ketorolac無法完全取代fentanyl之止痛效果，但ketorolac擁有較少中樞及呼吸之抑制作用，可提供有心肺疾病且必須接受電震波碎石術之患者另一種選擇。

OBJECTIVE: A single-blind, randomized control study was designed to compare the efficacy of a single intravenous dose of 30 mg ketorolac with that of 0.1 mg fentanyl in a shock wave lithotripsy (SWL) procedure for treatment of urolithiasis, and to monitor side effects. MATERIAL AND METHODS: From June to December 1999, 152 patients (108 males and 44 females) were enrolled, with 79 patients in the fentanyl group and 73 in the ketorolac group. Pain relief was assessed by a verbal rating scale (VRS) and a visual analog scale (VAS) at 5, 15, and 30minutes after the beginning of the SWL procedure. RESULTS: At each time point, patients in the fentanyl group showed more significant pain relief than did patients in the ketorolac group (p<0.05). There were 21 patients (28.8%) in the ketorolac group who needed intravenous 50 mg pethidine as rescue medication, while only 8 patients (10.1%) in the fentanyl group did. The difference is statistically significant (p<0.05). CONCLUSIONS: Ketorolac cannot completely replace fentanyl for pain control during SWL treatment of urolithiasis with respect to pain level over time and the number of patients requiring rescue medication, but its lower central and respiratory depression provides another choice for patients with cardiopulmonary diseases.