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A Mobile Outside-in Technique of Transforaminal Lumbar Endoscopy for Lumbar Disc Herniations

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Bleeding risk with ketorolac after lumbar microdiscectomy.

Kingsley R Chin¹, Hariharan Sundram, Paul Marcotte

¹Spine Surgery Service, Department of Orthopaedics, University of Pennsylvania Medical School, Philadelphia, PA 19104, USA. kingsleychin@hotmail.com

Journal of Spinal Disorders & Techniques

|April 7, 2007

Summary

A single dose of Ketorolac Tromethamine effectively reduced postoperative pain after microdiscectomy without increasing bleeding risks. This nonsteroidal anti-inflammatory drug supports same-day discharge for minimally invasive spine surgery patients.

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Area of Science:

Neurosurgery
Anesthesiology
Orthopedics

Background:

Minimally invasive spine surgeries aim for shorter hospital stays, necessitating improved postoperative pain management.
Ketorolac Tromethamine is effective for pain relief but raises concerns about postoperative bleeding in spinal procedures.

Purpose of the Study:

To assess the safety and efficacy of a single intraoperative dose of Ketorolac Tromethamine in reducing postoperative pain after microdiscectomy.
To evaluate the incidence of bleeding complications in patients receiving Ketorolac Tromethamine compared to a control group.

Main Methods:

Prospective study of 44 patients receiving a single 30 mg intraoperative dose of Ketorolac Tromethamine post-wound closure.
A control group of 45 patients underwent microdiscectomy without Ketorolac Tromethamine.

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Monitoring of postoperative bleeding, coagulation parameters, pain levels (Visual Analog Scale), and time to discharge.

Main Results:

No significant differences in postoperative coagulation parameters or surgical site bleeding were observed between the Ketorolac and control groups.
Patients receiving Ketorolac Tromethamine reported lower average postoperative Visual Analog Scale scores for leg pain (2.6) compared to the control group (4) two hours after surgery.
The study supported ambulatory surgery for microdiscectomy procedures.

Conclusions:

A single intraoperative dose of Ketorolac Tromethamine provides effective analgesia after microdiscectomy with no significant increase in bleeding risk.
Meticulous surgical hemostasis remains crucial before wound closure.
Extended postoperative use of Ketorolac Tromethamine presents a viable alternative to opioid analgesics.