Related Experiment Video
Updated: Dec 21, 2025
Acupoint Needle-Embedding Combined with Ironing Therapy for Postoperative Pain After Anal Surgery
Published on: June 23, 2023
Ketorolac after colectomy for ulcerative colitis in children: An analysis of opioid utilization and postoperative
Mark A Taylor1, William B West2, Stephen L Guthery3
1University of Utah, Department of Surgery, Division of Pediatric Surgery.
Insights
Ketorolac use after colectomy in children with ulcerative colitis did not increase postoperative complications. However, it did not reduce opioid use, suggesting further research is needed for safety and benefit in inflammatory bowel disease (IBD) patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Pharmacology
Background:
- Enhanced recovery protocols often use NSAIDs for pain management.
- Conflicting evidence exists regarding ketorolac's safety in inflammatory bowel disease (IBD), with concerns about disease flares and complications.
- Outcomes of ketorolac use in pediatric colectomy patients with IBD are not well-established.
Purpose of the Study:
- To evaluate ketorolac utilization in pediatric patients undergoing colectomy for ulcerative colitis.
- To assess the association between ketorolac administration and postoperative outcomes in this specific patient population.
Main Methods:
- Retrospective review of pediatric patients who underwent colectomy for ulcerative colitis between 2007 and 2017.
- Collection of data on patient demographics, operative details, medication use (including ketorolac), length of stay, and postoperative complications.
- Cohort comparison of patients who received postoperative ketorolac versus those who did not.
Main Results:
- Forty-five percent of the 60 pediatric patients received postoperative ketorolac.
- No significant differences were observed in length of stay, opioid exposure, readmission rates, or return to the operating room between the ketorolac and non-ketorolac groups.
- No documented cases of postoperative bleeding, acute kidney injury, or IBD flares were observed in children receiving ketorolac.
Conclusions:
- Ketorolac administration following colectomy in pediatric ulcerative colitis patients was not associated with an increase in postoperative complications.
- Ketorolac did not lead to decreased opioid analgesia utilization in this cohort.
- Further prospective studies are required to definitively establish the safety and efficacy of ketorolac in pediatric IBD patients undergoing colectomy.
Introduction:
Enhanced recovery protocols include multimodal perioperative pain control and frequently include use of NSAIDs. There is conflicting evidence that ketorolac use in inflammatory bowel disease (IBD) may precipitate disease flares and postoperative complications. The outcomes of children who receive ketorolac in this setting are not well known. We sought to evaluate ketorolac utilization in children following colectomy for ulcerative colitis.
Methods:
All patients undergoing colectomy for ulcerative colitis between 2007 and 2017 at a tertiary children's hospital were reviewed. We collected patient age, duration of symptoms, operative details, medication utilization, length of stay, and postoperative complications. We performed a cohort comparison of these variables across patients who did vs. did not receive postoperative ketorolac.
Results:
Sixty children were identified with median age at diagnosis of 12.6 years (IQR: 9.9-14.5). At colectomy, patients had a median PUCAI score of 60 (45-70), ESR 34 mm/h (15-50), hemoglobin 10.9 g/dL (9.3-12.9), and albumin 3.1 g/dL (2.4-3.8). Postoperatively, 45% (n = 27) received ketorolac. Patients in both cohorts had a similar length of stay, duration of opioid exposure, total morphine equivalents utilized, readmission rate, and unexpected return to the operating room. There were no documented cases of postoperative bleeding, acute kidney injury, or disease related flares among children receiving ketorolac.
Conclusions:
Administration of ketorolac after colectomy in IBD was not associated with an increase in any postoperative complications, though the study was underpowered to detect these differences. However, ketorolac administration did not lead to a decreased utilization of opioid analgesia. Further prospective research is necessary to understand whether ketorolac in this population is safe and offers benefit.
Type Of Study:
Retrospective study.
Level Of Evidence:
III.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:20Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
01:26Kidney Transplant II: Surgical Procedure
01:29Drugs for Treatment of Ulcerative Colitis in IBD