Analgesic Efficacy of Ketoprofen in

Postpartum, General Surgery,

and Chronic Cancer Pain
Abraham Sunshine, MD, and Nancy Z. Olson, MPS

This article summarizes the results of five single-dose clinical studies of three pain
models: postpartum, postoperative, and chronic cancer pain. The efficacy of ketoprofen
(in varying doses from 25 to 225 mg) was compared with one of the following standards:
aspirin (650 mg), codeine (90 mg), acetaminophen (650 mg) plus codeine (60 mg), and
parenteral morphine (5 mg and 10 mg). The results indicate that ketoprofen in doses as
low as 25 mg has analgesic properties significantly superior to those of placebo. For the
treatment of postpartum pain, ketoprofen was significantly more effective than aspirin
650 mg but not significantly different from codeine 90 mg. Ketoprofen doses of 50 mg and
150 mg also provided analgesia superior to that with acetaminophen 650 mg plus co-
deine 60 mg for the management of moderate to severe postoperative pain. Moreover,
oral doses of ketoprofen (75 and 225 mg) provided analgesia similar to that obtained with
5 and 10 mg parenteral doses of morphine. Adverse effects related to ketoprofen were
relatively minor and infrequent. Ketoprofen was recently approved for use as an analge-
sic for treatment of mild to moderate pain in total daily doses up to 300 mg; the recom-
mended initial dose is 25 to 50 mg every 6 to B hours as necessary.

K etoprofen, 2-(3-benzoylphenyl-propionic acid),

is a nonsteroidal anti-inflammatory drug
design and compared various dose levels of orally
administered ketoprofen with aspirin, codeine, acet-
(NSAID) with analgesic and antipyretic properties.! aminophen plus codeine, and intramuscularly ad-
Its mode of action appears to be similar to that qf ministered morphine. Although the type of pain in
other NSAIDs and includes inhibition of prostaglan- each study varied (Le., postpartum pain, general
din and leukotriene biosynthesis, antibradykinin surgery, and chronic cancer pain), the methods of
activity, and lysosome membrane-stabilizing ac- evaluation were essentially identical. Quantitative
tivity.2,3 differences in analgesia are dependent on type of
Ketoprofen has been studied in humans both as an pain.4 Postpartum pain is generally believed to be
antirheumatic and as an analgesic. Our summary less intense and therefore more appropriate for the
focuses on five independent studies (three of which evaluation of analgesics at lower doses. Postopera-
we performed) that were done to evaluate the anal- tive and chronic cancer pain, however, are more
gesic efficacy of ketoprofen in three different pain intense and are appropriate for the evaluation of an-
models: postpartum, general surgery, and chronic algesics at higher doses. In the latter two models of
cancer pain. more severe pain, the usual ketoprofen dose was
increased at least threefold, to 150 mg for postopera-
METHODS tive pain and up to 225 mg for chronic cancer pain.
The study subjects were selected from popula-
The same general methods were used in all of the tions of inpatients with the appropriate type of pain
studies under discussion. All studies met current who gave written informed consent to participate.
standards of well-controlled clinical trials. The stud- Patients with known allergic sensitivities to any of
ies had a double-blind, parallel-group, single-dose the study medications were excluded from the stud-
ies, as were patients with any complicating illness or
history of drug abuse. When the baseline pain of the
Address for correspondence and reprints: A. Sunshine, MD, 907 Fifth patients was moderate or severe, study medication
Avenue, New York, NY 10021. was administered by a nurse-observer. Observations

J elin Pharmacol 1988;28:847-854 547

 SUNSHINE AND OLSON

were made at 0.5 hour, 1 hour, and hourly thereafter RESULTS

for a period of 6 hours. At each observation, patients
were asked to assess the intensity of their pain, the Postpartum Pain
amount of their pain relief, and any side effects ex-
perienced. Pain intensity was recorded on a four- In the two postpartum studies (Studies 1 and 2), the
point scale ranging from 0 to 3 as 0 (none), 1 (slight), 2 efficacy of the same three dose levels of ketoprofen
(moderate), or 3 (severe). Pain relief was recorded on (25, 50, and 100 mg) was compared with that of two
a scale from 0 to 4, as 0 (none), 1 (a little), 2 (some), 3 different reference drugs (Table 1). Kantor et a1 9 used
(a lot), or 4 (complete). Also, at the last observation, codeine 90 mg as the active control and Sunshine et
patients were asked to make two global assessments: apo used aspirin 650 mg. Both studies comprised pa-
their overall impression of the medication on a scale tients with post episiotomy pain, uterine cramping,
of 0 to 3 as 0 (no help), 1 (fair), 2 (good), or 3 (excel- or postcesarean section pain. The greater percentage
lent), and a subjective assessment of their improve- of patients in each study (70% and 66% respectively)
ment on a scale of 1 to 7 as 1 (very much worse), had post episiotomy pain (Table I).
2 (much worse), 3 (a little worse), 4 (no change), 5 The mean values for the summary and global
(a little better), 6 (much better), or 7 (very much measures of analgesic efficacy for Studies 1 and 2 are
better). shown in Table II. The time effect curves for pain
relief are shown in Figures 1 and 2. In Study 1, all
three ketoprofen doses and codeine provided signifi-
Statistical Measures cantly (P < 0.05) greater analgesia than did placebo.
However, no statistically significant differences
Measures of analgesia were derived from the pain were seen between any dose of ketoprofen and co-
intensity and relief data. The pain intensity differ- deine. No dose-related response was observed with
ence (PID) score was calculated for each observation ketoprofen. In Study 2, all active treatments were
by subtracting the present pain intensity from the significantly (P < 0.05) superior to placebo. In addi-
initial pain intensity. The sum of the pain intensity tion, the two higher doses of keto profen were signifi-
differences (SPID) is the sum of the PID scores cantly (P < 0.05) more effective than aspirin in terms
weighted by the length of the interval between ob- of the 4-hour and 6-hour SPID and TOPAR scores,
servations, and is an estimate of the area under the and the 100 mg dose of ketoprofen had significantly
time-effect curve of the treatment. The variable (P < 0.05) higher scores for the two global measures.
TOPAR is the sum of the relief values also weighted Although the SPID and TOPAR scores for the low
by the length of the time interval between observa- dose of ketoprofen were not significantly different
tions. Percent SPID (%SPID) is defined as the ratio of from those for aspirin, ketoprofen 25 mg was given a
each patient's SPID score to the maximum possible SIgnificantly (P < 0.05) better global rating. Overall,
SPID (depending on the baseline intensity) there was an increase in the mean efficacy scores for
times 100. ketoprofen as the dose was increased from 25 mg to
To study the differences between treatments, a 50 mg but a lesser increase as the dose was increased
bioassay computer program5 performed as analysis from 50 mg to 100 mg, inp.icating a relatively flat
of variance (ANOVA) calculated as a one-way layout dose-response curve above 50 mg.
on each of the study variables and derived mea- ~ total of 10 patients had adverse effects in post-
sures. When the ANOVA was significant at the 0.05 partum Study 1. The most commonly reported ad-
level, pairwise contrasts between the treatments ve.rse effect was drowsiness, which occurred in
were carried out by the Tukey A test,6 by P(}ritz's seven patients. A significantly (P < 0.001) higher
modification of the Neuman-Keuls procedure/ or by number of adverse reactions occurred in the codeine
Duncan's multiple-comparison procedure, and treatment group (six patients) than in the 25, 50, or
Dunnett's "t" test8 was used to compare each active 100 mg ketoprofen groups (two, zero, and one pa-
treatment with placebo. tients, respectively) or in the placebo group (one pa-
For the five studies, the data were analyzed using tient). r-Jo side effects were reported in Study 2.
all 6 hours of the observation period. In addition, the
analyses were performed as if the studies had lasted Postoperative Pain
only 4 hours because the reference drugs (Le.,
aspirin, codeine, acetaminophen, and morphine) are In studies 3 (Sunshine et aI, unpublished data) and
not usually administered on a dose regimen longer 4,11 the efficacy of ketoprofen (50 mg and 150 mg),
than 4 hours. For Study 1, data are presented here the combination of acetaminophen (650 mg) plus
that were not contained in the original publication. codeine (60 mg), and placebo were compared for the

548 • Jell" PharmacoI1988j28:S47-S54

 TABLE I

Summary of Studies
Pain Type* Sample Size Dose
Study (% of pts) (Sex) Treatment (mg)

Study 1 Postpartum 150 Placebo

(Kantor et al)9 Postepisiotomy (70%) (100% F) Ketoprofen 25
Uterine cramps (25%) Ketoprofen 50
Cesarean section (5%) Ketoprofen 100
Codeine 90
Study 2 Postpartum 156 Placebo
(Sunshine et al)10 Postepisiotomy (66%) (100% F) Ketoprofen 25
Uterine cramps (31%) Ketoprofen 50
Cesarean section (3%) Ketoprofen 100
Aspirin 650
Study 3 General surgery 123 Placebo
(Sunshine et ai, (100% M) Ketoprofen 50
unpublished Ketoprofen 150
data) Acetaminophen 650
+ Codeine 60
Study 4 General surgery 160 Placebo
(Turek and (50% F) Ketoprofen 50
Baird)l1 (50% M) Ketoprofen 150
Acetaminophen 650
+ Codeine 60
Study 5 Chronic cancer 123 Ketoprofen 75 (p.o.)
(Sunshine et ai, (40% F) Ketoprofen 225 (p.o.)
unpublished (60% M) Morphine 5 (Lm.)
data) Morphine 10 (Lm.)
• All patients in these studies had moderate or severe pain at baseline and were observed at ~. 1. 2, 3, 4, 5, and 6 hours after receiving the test medication.

TABLE II
Postpartum Pain: Mean Values for Summary Measures of Analgesic Efficacy
Study 1 Study 2
Ketoprofen Ketoprofen Ketoprofen Codeine Ketoprofen Ketoprofen Ketoprofen Aspirin
Placebo 25 mg 50 mg 100 mg 90 mg Placebo 25 mg 50 mg 100mg 650mg
Variables (n = 30) (n = 29) (n = 31) (n = 31) (n = 29) (n = 31) (n = 31) (n = 32) (n = 32) (n = 30)
SPID
4 hr 2.9 5.8* 5.2* 5.6* 6.0* 2.7 5.0* 5.7*# 5.9*# 4.2*
6 hr 3.9 9.0* 7.8* 8.5* 8.4* 4.2 7.1 * 8.1*# 8.1*# 5.9
TOPAR
4 hr 5.3 10.5* 9.4* 10.0* 10.2* 4.2 8.1 * 8.7*# 9.3*# 6.4
6 hr 7.3 16.1 * 13.8* 15.2* 14.5* 6.4 11.6* 12.4*# 12.9*# 9.0
Patient's global
assessments
Overall
improvement"
Rating of 4.6 5.9* 5.9* 6.1 * 5.8* 5.0 5.7* 5.9* 6.0*# 5.3
medication b 1.2 2.3* 2.1 * 2.3* 2.1 * 1.5 2.3*# 2.2* 2.2*# 1.7
• Significantly (P :s; 0.05) different from placebo. ment; based on rating scale of 1 = very much worse to 7 = very much better.
# Significantly (P :s; 0.05) different from aspirin 650 mg. b The higher the value the better the patient's rating of the study medication;
• The higher the value the better the patient's evaluation of overall improve· based on a rating scale of 0 = no help to 3 = excellent.

SUPPLEMENT 549
 SUNSHINE AND OLSON

treatment of pain secondary to general surgery.

These two studies followed a similar protocol. Study
3 was performed at a Veterans Administration hos-
2.5
pital, and therefore all the patients were male,
whereas Study 4 had both male and female patients.
The baseline levels of pain intensity were compara-
ble among the four treatment groups in each study.
The time-effect curves for pain relief are shown in
Figures 3 and 4. In Study 3, both ketoprofen doses (50
and 150 mg) were significantly (P < 0.01) superior to
placebo from hour 2 through hour 6. Acetamino-
phen (650 mg) plus codeine (60 mg) was significantly
(P < 0.01) superior to placebo at hours 2 and 3. There
0.5
were no significant hourly differences among the
active treatments. However, the mean efficacy
scores for acetaminophen plus codeine were higher
HOURS AFTER DRUG ADMINISTRATION
at the first hour and then plateaued and decreased in
effect, whereas the scores for ketoprofen were
higher at the second hour and this trend was sus-
Figure 1. Time-effect curve for pain relief: Study l-Postpartum tained. In Study 4, the mean pain relief scores for
pain.9 Mean pain relief scores for each study group were derived both ketoprofen doses (50 and 150 mg) were signifi-
from patient responses which had been scored on a five-point
scale: 0 = no relief. 1 = a little relief. 2 = some relief. 3 = a lot of
cantly superior to placebo from hours 1 through 6
relief. and 4 = complete relief. • - - •• placebo (n = 30); D - - - D. and the ranking of the drugs was similar to Study 3.
ketoprofen 25 mg (n = 29); X - - - - - X. ketoprofen 50 mg (n = 31); Acetaminophen (650 mg) plus codeine (60 mg) had
.......... ketoprofen 100 mg (n = 31); t:. - - t:.. codeine 90 mg (n significantly (P < 0.05) higher pain relief scores than
= 29).
placebo at hours 1 through 4. In addition, the mean
pain relief scores for both ketoprofen groups were
significantly (P < 0.05) higher than those for acet-

2.5 2.5
. {:::::::::::~::::~~:-:--x-::~::'--·'.~~::".-.';::x
.?e----El
~.? '~

~ ~
/'r</ '~ '-s--
iii
'"
iii
'" : .
~1.5 1.5 X/ii'
0-
z
"'"
;'t
z
~
:a ""
:;g

0.5 0.5

HOURS AfTER DRUG ADMINISTRATION HOURS AFTER DRUG ADMINISTRATION

Figure 2. Time-effect curve for pain relief: Study 2-Postpartum Figure 3. Time-effect curve for pain relief: Study 3-Postoperative
pain. to Mean pain relief scores for each study group were derived pain. Mean pain relief scores for each study group were derived
from patient responses which had been scored on a five-point from patient responses which had been scored on a five-point
scale: 0 = no relief. 1 = a little relief. 2 = some relief. 3 = a lot of scale: 0 = no relief. 1 = a little relief. 2 = some relief. 3 =, a lot of
relief. and 4 = complete relief.. - - •• placebo (n = 31); D - - - D. relief. and 4 = complete relief. • - - •• placebo (n = 31);
ketoprofen 25 mg (n = 31); X - - - - - X. ketoprofen 50 mg (n = 32); X - - - - - X. ketoprofen 50 mg (n = 32); .......... ketoprofen 150 mg
.......... ketoprofen 100 mg (n = 32); t:. - - t:.. aspirin 650 mg (n (n = 31); D - - - D. acetaminophen 650 mg + codeine 60 mg (n
= 30). = 25).

550 • J elin PharmacoI1988;28:S47-S54

 ANALGESIC EFFICACY OF KETOPROFEN

aminophen plus codeine at the 4-, 5-, and 6-hour

evaluations.
The mean values for the summary and global
2.5 measures of analgesic efficacy for these studies are
shown in Table III. In Study 3, both doses of keto-
profen were significantly more effective than pla-
cebo by many measures, including 4- and 6-hour
SPID and TOPAR scores and the patient global as-
--x sessments (overall improvement and rating of the
study medication). The mean 4-hour TOPAR scores
and the mean patients' overall improvement scores
for acetaminophen plus codeine were significantly
0.5
(P < 0.05) superior to those for placebo. Ketoprofen at
both dose levels was significantly (P < 0.05) more
efficacious than acetaminophen plus codeine ac-
cording to the 6-hour %SPID and the patients' as-
HOURS AffiR DRUG ADMINISTRATION
sessment of overall improvement.
Study 4 had similar findings. Ketoprofen (50 mg
and 150 mg) was significantly (P < 0.05) more effec-
Figure 4. Time-effect curve for pain relief: Study 4-Postoperative tive than placebo according to the 4- to 6-hour SPID
pain." Mean pain relief scores for each study group were derived and TOP AR scores and the two patient global as-
from patient responses which had been scored on a five-point sessments. Acetaminophen plus codeine was signifi-
scale: 0 = no relief, 1 = a little relief, 2 = some relief, 3 = a lot of
relief, and 4 = complete relief. X - - - - - X, ketoprofen 50 mg (n cantly (P < 0.05) more effective than placebo ac-
= 41); '"" ... '"", ketoprofen 150 mg (n = 39); 0 - - - 0, acetamino- cording to the 4-hour SPID and TOPAR scores and
phen 650 mg + codeine 60 mg (n = 39); _ - - _, placebo (n = 41). the two global assessments. Ketoprofen 150 mg pro-

TABLE III

Postoperative Pain: Mean Values for Summary Measures of Analgesic Efficacy

Study 3 Study 4@
Ketoprofen Ketoprofen Acetaminophen 650 mg Ketoprofen Ketoprofen Acetaminophen 650 mg
Placebo 50 mg 150 mg + Codeine 60 mg Placebo 50 mg 150 mg + Codeine 60 mg
Variables (n = 32) (n = 32) (n = 31) (n = 28) (n = 41) (n = 41) (n = 39) (n = 39)

SPID
4 hr 3.2 5.3* 5.5* 4.4 1.7 4.1 * 4.5* 3.5*
6 hr 5.0 8.1 * 8.5* 5.9 2.2 5.6* 6.2*# 4.1
% SPID
6 hr 29.4 48.8*# 50.3*# 34.5 NA NA NA NA
TOPAR
4 hr 6.3 9.3* 9.5* 8.6* 3.7 8.4* 8.6* 7.0*
6 hr 9.5 14.6* 14.8* 12.2 4.6 11.4*# 12.2*# 8.1
Patient's global
assessments
Overall
improvement"
Rating of 4.7 5.3*# 5.4*# 4.9* 3.6 5.0* 5.3*# 4.4*
medication b 1.5 2.1* 2.2* 1.9 1.0 2.0* 1.9* 1.7*
@ NA = not available. ment; based on rating scale of 1 = very much worse to 7 = very much better.
• Significantly (P < 0.05) different from placebo. b The higher the value the better the patient's rating of the study medication;

# Signficantly (P < 0.05) different from acetaminophen plus codeine. based on a rating scale of 0 = no help to 3 = excellent.
• The higher the value the better the patient's evaluation of overall improve-

SUPPLEMENT S51
 SUNSHINE AND OLSON

vided significantly (P < 0.05) better analgesia than frequent in the acetaminophen plus codeine group
acetaminophen plus codeine for 6-hour SPID and than in the ketoprofen 150 mg group. One patient in
TOPAR scores and the patient's overall improve- the ketoprofen 50 mg group complained of angina
ment. The:t:esults of these two studies indicate that pectoris, which was determined by the investigators
the analgesic;:: efficacy of ketoprofen at both doses is not to be treatment-related.
equal to, and for some assessments greater than, that
of acetaminophen plus codeine for the management Chronic Cancer Pain
of moderate to severe postoperative pain.
There were no statistically significant treatment Study 5 differed from the other four studies reported
differences in the number of patients reporting ad- here in that it was designed to determine the po-
verse reactions in Study 3. Three patients (2%) re- tency of oral ketoprofen (75 mg and 225 mg) relative
ported adverse effects in Study 3: two patients who to parenteral morphine (5 mg and 10 mg) (Sunshine
received ketoprofen 50 mg and one patient who re- et aI, unpublished data). As the study was double- .
ceived the acetaminophen plus codeine combina- blind, each patient received three capsules and an
tion. One ketoprofen-treated patient complairied of injection. The study was terminated because of poor .
sedation and lethargy and the second complained of patient enrollment. The mean values for the sum-
chest pains that were believed to be unrelated to the mary and global measures of analgesic efficacy are
study medication. The patient who received acet- shown in Table IV. The time-effect curve for pain
aminophen plus codeine reported dizziness and eu- relief is shown in Figure 5.
phoria. On the basis of the time-effect curve, morphine 5
A total of 37 (23%) patients reported side effects in mg was the least effective treatment (Figure 5). At
Study 4; eight patients in the ketoprofen 150 mg the half-hour and 1 hour evaluations, morphine 10
group, 14 in the ketoprofen 50 mg group, 11 in the mg had the highest mean pain relief scores, which
acetaminophen plus codeine group, and 4 patients in plateaued and diminished in effect after 2 hours.
the placebo group. Significantly (P < 0.05) more pa- Ketoprofen 225 mg had mean pain relief scores
tients in the acetaminophen plus codeine group and around the same level as 5 mg of morphine at the
the ketoprofen 50 mg group had adverse effects as half-hour and 1 hour evaluations but had the high-
compared to the placebo group. Most symptoms est mean pain relief scores from hours 2 through 6.
were associated with the gastrointestinal and ner- Ketoprofen 75 mg was less effective than the higher
vous systems; gastrointestinal system symptoms dose but had a similar time-effect curve. Multiple
were approximately evenly distributed among the pairwise comparisons based on the Tukey A test
active treatIIient groups, whereas the nervous sys- showed that ketoprofen 225 mg was significantly (P
tem side effects were significantly (P < 0.05) more < 0.05) superior to morphine 5 mg from hour 3

TABLE IV
Chronic Cancer Pain: Mean Values for Summary Measures of Analgesic Efficacy (Study 5)
Morphine 5 mg i.m. Morphine 10 mg i.m. Ketoprofen 75 mg p.o. Ketoprofen 225 mg p.o.
Variables (n = 29) (n = 30) (n = 32) (n = 32)

SPID
4 hr 4.8 6.1 6.3 7.0
6 hr 6.8 8.9 9.5 10.7
TOPAR
4 hr 8.7 10.6 10.9 11.7
6 hr 12.3 15.3 16.1 17.5
Patient's global
assessments
Overall improvement" 4.5 5.1 5.4 5.6
Rating of medication b 1.5 2.0 2.0 2.1
• The higher the value the better the patient's evaluation of overall improve- b The higher the value the better the patient's rating of the study medication;
ment; based on rating scale of 1 = very much worse to 7 = very much better. a
based on a rating scale of = no help to 3 = excellent.

552 • J elin Pharmac;ol 1988;28:547-554

 ANALGESIC EFFICACY OF KETOPROFEN

through hour 6 for PID and at hour 4 for relief and

3.5
the summary variable SPID.
Statistically significant regressions for morphine 5
and 10 mg and ketoprofen 75 and 225 mg were not
demonstrated. However, the "preparation effect,"
2.5
i.e., the average for the two morphine groups con-
trasted with the average for the two ketoprofen g
groups, was statistically significant for many vari- ~

ables, including SPID and the global measure of the ;'."

z
«
patient's overall improvement; oral ketoprofen was :i!
1.5

significantly superior to intramuscular morphine

according to the preparation test. These results do
not permit a reliable estimate of relative potency,
0.5
but the data suggest that ketoprofen administered
orally in the doses studied is equal to or more effec-
tive than morphine administered parenterally.
Four (3%) patients reported adverse effects: two
HOURS AFTER DRUG ADMINISTRATION
who received morphine 10 mg, one who received
morphine 5 mg, and one who received ketoprofen
225 mg: The morphine-treated patients complained Figure 5. Time-effect curve for pain relief: Study 5-Chronic cancer
of nausea, dizziness, and vomiting. The patient pain. Mean pain relief scores for each study group were derived
from patient responses which had been scored on a five-point
treated with ketoprofen 225 mg complained of nau- scale: a = no relief, 1 = a little relief, 2 = some relief, 3 = a lot of
sea, vomiting, and anxiety. In general, ketoprofen, relief, and 4 = complete relief. • - . , morphine 5 mg (n = 29);
even at the higher dose, was well tolerated. D - - - D, morphine 10 mg (n = 28); X - - - - - X, ketoprofen 75 mg
(n = 32); ••• '., ketoprofen 225 mg (n = 32).

DISCUSSION
analgesic, significantly (P < 0.05) superior to placebo
(Table V). In addition, the 50 and 100 mg doses of
The results of five studies in three different pain ketoprofen were significantly (P < 0.05) more effec-
models showed ketoprofen overall to be an effective tive than aspirin 650 mg in one postpartum study,

TABLE V

Summary of Analgesic Activity of Ketoprofen in the Five Single-dose Studies

Control Agent Ketoprofen
Pain Model Dose (mg) Na Dose (mg) Na Results

Postpartum COD 90 29 25 29 K25, 50, 100 = COD> PLA

Study #1 9 PLA 30 50 31
100 31
Study #2 10 ASA 650 30 25 31 K25 = ASA > PLA
PLA 31 50 32 K50 > ASA > PLA
100 32 K100> ASA > PLA
General Surgery APAP 650 +
Study #3 COD 60 28 50 32 K50, 150> A + C > PLA
PLA 32 150 31
Study #4 11 APAP 650 +
COD 60 39 50 41 K50, 150> A + C > PLA
PLA 41 150 39
Chronic Cancer MaR 5 i.m. 29 75 p.o. 32 See text
Study #5 MaR 10 i.m. 30 225 p.o. 32
• Number of patients eligible for efficacy analysis ASA = aspirin, K = Ketoprofen, PLA = placebo, COD = codeine, APAP = acet-
aminophen, MaR = Morphine.

SUPPLEMENT 553
 SUNSHINE AND OLSON

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854 • J elin Pharmacol 1988;28:547-554