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Clinical experience with ketorolac in children
1Department of Pharmacy, University of Virginia, Charlottesville 22908.
Insights
Parenteral ketorolac is safe and effective for pediatric pain management when used appropriately. This study found few adverse effects in children receiving ketorolac for analgesia.
Area of Science:
- Pediatric pharmacology
- Pain management
- Clinical therapeutics
Background:
- Parenteral ketorolac is a non-steroidal anti-inflammatory drug used for pain relief.
- Limited data exists on its use in large pediatric populations.
Purpose of the Study:
- To evaluate the dosing patterns, efficacy, and safety of parenteral ketorolac in children.
- To describe the clinical use of ketorolac in a pediatric medical center.
Main Methods:
- Observational, prospective study over four months in a 122-bed children's medical center.
- Included children receiving ketorolac for analgesia or antipyresis.
- Assessed indications, dosing, duration, efficacy, and adverse events.
Main Results:
- 112 children received ketorolac; 110 for analgesia, 2 for fever.
- Common dose was 0.5 mg/kg every 6 hours; average therapy duration was 3.4 days.
- Adverse reactions were rare, with only 2 cases of potential ketorolac-associated bleeding.
Conclusions:
- Parenteral ketorolac is a safe and effective option for pediatric pain management.
- Appropriate dosing and limited duration are key to its safe use in children.
- Further research can explore long-term outcomes and specific indications.
Objective:
To describe the use of parenteral ketorolac in a large population of children, focusing on dosing patterns, efficacy, and safety.
Design:
Observational, prospective study conducted over a four-month period.
Setting:
A 122-bed children's medical center located within an academic medical center hospital.
Participants:
Children receiving ketorolac during their hospitalization.
Main Outcome Parameters:
Indications for treatment, dose, dosing interval, use of a loading dose, length of therapy, efficacy (subjective response and use of concomitant therapy), and adverse effects (bleeding, gastrointestinal ulceration or vomiting, and renal dysfunction).
Results:
Of 112 children evaluated, 110 received ketorolac for analgesia, and 2 were given ketorolac as an antipyretic. The children ranged in age from 6 months to 19 years. Doses of 0.5 mg/kg q6h were used for most children (range 0.17-1.0). The average length of therapy was 3.4 days (range 1-12). The most frequent reason for discontinuing ketorolac therapy was a change to oral therapy. Therapy was discontinued because of a lack of efficacy in only 2 children. Adverse reactions were unusual, with only 2 patients having bleeding potentially associated with ketorolac use.
Conclusions:
Ketorolac appears to be a safe and effective therapy for children when given in appropriate doses for a limited duration.
