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Ketorolac for pain management after abdominal surgical procedures in infants
Randall S Burd1, Joseph D Tobias
1Department of Surgery, Children's Hospital at University of Missouri Hospitals and Clinics, Columbia, USA.
Insights
Intravenous ketorolac in infants under six months may reduce morphine needs and side effects after abdominal surgery. Further research is recommended for this pain management strategy.
Area of Science:
- Pediatric Surgery
- Pharmacology
- Pain Management
Background:
- Intravenous ketorolac use in infants under six months is not well-documented.
- Ketorolac may mitigate opioid use and associated side effects in this vulnerable population.
- This study aimed to develop recommendations for ketorolac use in infants post-abdominal surgery.
Purpose of the Study:
- To evaluate the efficacy of intravenous ketorolac in reducing opioid requirements in infants undergoing abdominal surgery.
- To assess the safety and effectiveness of ketorolac as an adjunct to morphine for postoperative pain management in young infants.
Main Methods:
- Retrospective review of medical records of infants under six months old.
- Comparison of pain management strategies: ketorolac plus morphine versus morphine alone.
- Data collection focused on opioid requirements within the first 48 hours post-surgery.
Main Results:
- Infants receiving ketorolac required significantly less morphine compared to those receiving morphine alone.
- A notable proportion of infants (four out of ten) on ketorolac did not require any supplemental morphine.
- Ketorolac demonstrated potential in reducing opioid consumption in this cohort.
Conclusions:
- Intravenous ketorolac effectively reduces morphine requirements in infants under six months following abdominal surgery.
- Ketorolac shows promise as a strategy to minimize opioid-related adverse effects in pediatric surgical patients.
- Further investigation into ketorolac's role in pediatric pain management is warranted.
Background:
While the use of intravenous ketorolac in infants less than 6 months old has not been previously reported, ketorolac may reduce opioid use and prevent opioid-associated side effects that are frequent in this age group. We reviewed our experience with ketorolac in infants to develop recommendations for using it after abdominal surgery.
Methods:
We reviewed the records of 10 infants less than 6 months old who received ketorolac supplemented with morphine and 8 infants who received morphine alone for pain after abdominal surgery.
Results:
Infants receiving ketorolac required less morphine than infants receiving morphine alone in the first 48 hours after surgery. Four patients receiving ketorolac did not require any supplemental morphine.
Conclusions:
Ketorolac reduces the amount of morphine required after abdominal surgery in infants less than 6 months old. The use of ketorolac deserves further study as a method of reducing opioid-associated adverse effects in this patient group.