Bleeding and ketorolac use in pediatric circumcision.

Area of Science:

• Pediatric Surgery
• Pain Management
• Anesthesiology

Background:

• Circumcision is a common pediatric surgical procedure.
• Ketorolac is an effective pain management option.
• Concerns exist regarding ketorolac's potential to increase bleeding risk.

Purpose of the Study:

• To compare the risk of clinically significant postoperative bleeding after pediatric circumcision with and without intraoperative ketorolac administration.

Main Methods:

• Retrospective cohort study of 743 pediatric patients (1-18 years) undergoing isolated circumcision.
• Clinically significant bleeding defined as requiring intervention within 24 hours.
• Interventions included hemostats, sutures, or return to OR.

Main Results:

• 42.3% received ketorolac (0.5 mg/kg), 57.7% did not.
• Bleeding requiring intervention occurred in 0.32% of the non-ketorolac group vs. 0.93% of the ketorolac group.
• No statistically significant difference in bleeding rates (p=0.403).

Conclusions:

• Intraoperative ketorolac administration is not associated with a statistically significant increase in postoperative bleeding after pediatric circumcision.
• Ketorolac may be a safe option for multimodal pain control in this patient group.
• Further research is warranted to confirm these findings.