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