Ketorolac in Acute Pancreatitis

Inclusion Criteria: * 18 years old * opioid order for pain secondary to acute pancreatitis * diagnosis of acute pancreatitis defined by the presence of two of the following three criteria: abdominal pain, lipase \> 3x upper limit of normal, and/or findings of AP on imaging * a patient with acute-on-chronic pancreatitis that does not exhibit elevated lipase levels is eligible for inclusion if the patient has the other two criteria * received at least 3 L of IV crystalloid fluid within first 24 hours of admission to ensure patients have received initial volume expansion * hemodynamically stable represented by a mean arterial blood pressure (MAP) of ≥65 mmHg * female patients not documented in chart as post-menopause must have a negative pregnancy test Exclusion Criteria: * history of chronic heart failure * history of acute coronary syndrome (ST-elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI)) within last 6 months * history of ischemic or hemorrhagic stroke within last 6 months * history of upper gastrointestinal bleed (GI) within last 6 months * history of inflammatory bowel disease * history of cirrhosis * any overt, active bleeding requiring blood transfusion * considered to be high bleed risk (platelet \< 50,000/mcL) * pregnant or breastfeeding * prisoners * cognitively impaired patients: not alert and oriented to person, place, and time (patient must be able to consent) * allergy to NSAIDs, ketorolac, or aspirin * admission to an intensive care unit * evidence of infected pancreatitis (i.e. abscess) on imaging studies * acute kidney injury or chronic kidney disease with CrCl\<30