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Ketorolac after congenital heart surgery: does it increase the risk of significant bleeding complications?

Anuja Gupta1, Casey Daggett, Joseph Ludwick

  • 1Childrens Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA. doctoranuja@yahoo.com

Paediatric Anaesthesia
|January 29, 2005
PubMed

Insights

Ketorolac use after pediatric congenital heart surgery did not increase bleeding risk requiring surgical intervention. This study suggests ketorolac is safe for managing pain in these young patients.

Area of Science:

  • Pediatric Cardiac Surgery
  • Pharmacology
  • Postoperative Care

Background:

  • Concerns exist regarding ketorolac's potential for bleeding complications in pediatric cardiac surgery.
  • This study addresses the safety of routine ketorolac use in this vulnerable population.

Purpose of the Study:

  • To evaluate the association between postoperative ketorolac administration and significant bleeding requiring surgical exploration in infants and children undergoing congenital heart surgery.

Main Methods:

  • Retrospective chart review of 842 pediatric patients undergoing congenital heart surgery.
  • Comparison of 94 patients receiving postoperative ketorolac with 94 matched controls not receiving ketorolac.
  • Outcome measured: postoperative bleeding necessitating surgical exploration.

Main Results:

  • No patients (0%) in the ketorolac group required surgical exploration for bleeding, compared to 4.2% in the non-ketorolac group.
  • The relative risk for bleeding requiring surgical exploration was 0.2 (95% CI 0.02-1.67) for the ketorolac group.
  • Ketorolac was administered to 11.1% of the study cohort.

Conclusions:

  • Postoperative ketorolac administration in infants and children following congenital heart surgery is not associated with a significant increase in bleeding complications requiring surgical intervention.
  • Findings support the judicious use of ketorolac for pain management in this patient population.
Abstract

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