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Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

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Reevaluating Single-Dose Ketorolac for Primary Palatoplasty Postoperative Pain Management.

Athena Zhang1, Sofia A Finestone1, Jonathan Chestang1

  • 1Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|December 18, 2025
PubMed
Summary
This summary is machine-generated.

Single-dose ketorolac after primary palatoplasty improves early pain control without increasing complications. This non-steroidal anti-inflammatory drug offers potential benefits for pediatric surgical recovery.

Keywords:
Toradolcleft palateketorolacopioidpain managementpalatoplastypediatrics

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Area of Science:

  • Pediatric Surgery
  • Pharmacology
  • Pain Management

Background:

  • Palatoplasty is a common pediatric surgical procedure.
  • Effective pain management is crucial for recovery after palatoplasty.
  • Opioid use is associated with significant side effects in pediatric patients.

Purpose of the Study:

  • To evaluate the safety of a single postoperative dose of ketorolac following primary palatoplasty (PP).
  • To assess ketorolac's efficacy in reducing opioid consumption and improving recovery metrics.
  • To compare outcomes between patients receiving and not receiving ketorolac.

Main Methods:

  • Prospective cohort study with historical controls at a tertiary pediatric hospital.
  • 124 patients received a single IV dose of ketorolac post-PP; 125 did not.
  • Safety outcomes included bleeding and oxygen needs; efficacy outcomes used FLACC scale, opioid use, and time to oral intake.

Main Results:

  • No significant differences in bleeding, oxygen requirements, or adverse events between groups.
  • Ketorolac group showed significantly lower FLACC scores in the first 4 hours post-surgery.
  • Trends suggested lower opioid use, earlier oral intake, and shorter hospital stay in the ketorolac group.

Conclusions:

  • Immediate postoperative single-dose ketorolac is safe after primary palatoplasty.
  • Ketorolac improves early postoperative pain control without increasing complication rates.
  • Further research is warranted for other potential benefits observed.