Inhibition of perioperative platelet aggregation using toradol (ketorolac)

Traditionally, aspirin is used as an inexpensive and usually well-tolerated agent to accomplish inhibition of platelet aggregation after microvascular surgery. Occasionally, however, aspirin is contraindicated. We have successfully used Toradol (ketorolac) after microvascular tissue transfer to inhibit platelet aggregation postoperatively, and documented this in our laboratory. We present two individuals on our surgical service requiring microvascular free tissue transfer with documented allergic reactions to aspirin. Platelet function was successfully suppressed while on the Toradol regimen, and this function returned to normal within 24 hours after stopping this therapy. We believe this agent may have some use for the microvascular surgeon for the population of patients in which aspirin is contraindicated or difficult to administer.