Related Experiment Video
Updated: Sep 19, 2025
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Ketorolac does not increase postoperative hemorrhage and limits narcotic use in pediatric patients undergoing
Elizabeth D Fisher1, Julia Gm Carter2, Michelle Tsao3
1Northwestern University Feinberg School of Medicine, Department of Otolaryngology, Chicago, IL, USA.
Background:
Conflicting evidence regarding the safety of perioperative ketorolac in children undergoing intracapsular tonsillectomy has led to some providers avoiding the use of ketorolac. However, emerging evidence indicates that ketorolac may be a safe option for pain control in these patients.
Methods:
We conducted a single-center retrospective cohort study of children undergoing intracapsular tonsillectomy. Exposures were children who received perioperative pain control with ketorolac compared to children who did not receive perioperative pain control with ketorolac. The primary study outcome was post tonsillectomy hemorrhage (PTH) requiring operative control. Secondary outcomes were post operative pain readmission, time spent in the PACU, and opioids administered in the PACU.
Results:
1594 patients fit inclusion criteria; 743 received ketorolac (46.6 %) and 851 did not receive ketorolac (53.4 %). There was no difference in rate of PTH requiring operative control in patients who received ketorolac compared to patients who did not (0.7 % vs 1.4 %, Chi-square test, p = 0.1415). There was no difference in the rate of postoperative pain readmission between the two groups (2.0 % vs 3.1 %, Mid-P test, p = 0.167). The median time spent in the PACU was 13.4 % less in the ketorolac group (48 min vs 58 min, multivariate linear regression, p < 0.001). The mean total opioid dose given in the PACU was significantly less in the ketorolac group (3.7 morphine milligram equivalents (MME) vs 5.3 MME, t-test, p < 0.001).
Conclusion:
In this cohort of children undergoing intracapsular tonsillectomy, there was no difference in the rate of PTH requiring operative control in children who received perioperative ketorolac compared to children who did not receive perioperative ketorolac. In addition, children who received ketorolac received lower total amonuts of opioids in the perioperative period and spent less time in the PACU. Further prospective, randomized clinical trials are necessary to confirm the impact of ketorolac in this population.
More Related Videos
03:57Author Spotlight: Exploring Corneal Innate Immunity and Delayed Wound Healing in Diabetic Patients
Published on: January 10, 2025
05:39Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Related Concept Videos
01:26Tonsillitis II: Management
01:30Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
01:13Local Anesthetics: Pharmacokinetics
01:24Parenteral Anesthetics: Overview
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...
01:23Local Anesthetics: Common Agents and Their Applications
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...