Wednesday, June 13, 2007

dr. wiki

A couple of weeks ago, when I was still on my Pain rotation, a group of us were discussing something about drug dosing (the equianalgesic dosing of ketorolac as compared to morphine, if you must know--yes, and now that you are fully asleep, I can steal your wallet), and not coming to any sort of agreement as to what the actual conversion was.* Academic bickering turned into a library disassembling quest for some hard facts, as we started combing through all the available textbooks at hand for a conversion table. Only for some reason, no reliable conversion could be found, even in the old warhorses (Miller, Barash et al.). Which meant that it was time for the secret weapon.

I think it's time to ask Dr. Google.

Oh yeah! Google it!

Maybe there's some research article that we can pull up.
Oh wait, here's some random Korean study that shows the Toradol:mophine ratio is about 1:6. That sounds about right. Let's go on PubMed and see what else is out there.

Forget PubMed and Dr. Google, man! Ask Dr. Wiki!

Who the hell is Dr. Wiki?


Oh my god, please tell me that you do not get your medical information from Wikipedia.

They have everything on there!

Yeah, I mean, if I wanted to know everything there was to know about Diff'rent Strokes, maybe I would go to Wikipedia, but for chrissake, you're a doctor, man! You can't look up stuff on Wikipedia!

I'm just saying, they have everything on there.

Hey, I love me some internet, and I don't know how people did research and traded information without it. But man, trusting Dr. Wiki is taking it one step too far. He's like the chiropractor that takes out ads on the subway.

(To his credit, I think that Resident #3 was kidding.)


[ * All of us had been told sort of anecdotally that 30mg of Toradol = 6mg of morphine, but Big Blue says 10mg of Toradol = 6mg of morphine. This was the only text we could find that stated the conversion so baldly, but we had a hard time believing it, since a.) Big Blue is notoriously full of typos, and b.) We usually load with 30mg of Toradol in the OR, and no one's experience has been that it provides anywhere near the analgesia of 18mg of morphine, or even 10mg of morphine. It's a great adjunct to the opiates we use (when not medically contraindicated), but I haven't had many post-surgical patients totally comfortable on Toradol alone. Maybe other people have different experiences?]


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