Post-Operative Ketorolac in Children After Crohn's Ileocecectomy

To investigate complications and flare rates in children with Crohn's disease who received ketorolac following ileocecectomy.

Electronic medical record data of patients < 18 years with Crohn's disease undergoing ileocecectomy at a single institution from 1/1/2013-9/1/2023 were retrospectively reviewed. Demographics, operative course, 30-day complications, and Crohn's flares, small bowel obstructions (SBO), and strictures within two years were collected. Patients who received post-operative ketorolac were compared to those who did not.

191 patients met criteria. 169(88.5%) received ketorolac and 22(11.5%) did not. Median age was 15.9[14.2, 17.8] years. Age, sex, pre-operative steroid use, biologic use, and labs were similar between groups. The majority (97.9%) were laparoscopic-assisted. Post-operatively, ketorolac-exposed patients required significantly less opioids (17.0[3.9, 35.2] morphine milli-equivalents vs. 39.7[8.4, 58.7], p = 0.048). Length of stay, days to first flatus, and days to ambulation were similar. There were 18(9.4%) 30-day complications, with no differences between groups. There was no difference in the number of Crohn's flares (3(1.8%) vs. 1(4.5%), p = 0.39), SBOs (8(4.7%) vs. 0(0%), p = 0.6), or strictures (1(0.6%) vs. 0(0%), p > 0.99).

In this single-institution analysis, no association between post-operative ketorolac and Crohn's flares was detected, though further study is required. Patients who receive ketorolac may benefit from decreased opioid consumption.