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Intraoperative ketorolac and posttonsillectomy bleeding

J H Judkins1, T G Dray, R N Hubbell

  • 1Department of Surgery, University of Vermont, Burlington, USA.

Archives of Otolaryngology--Head & Neck Surgery
|September 1, 1996
PubMed
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Intraoperative ketorolac tromethamine use during tonsillectomy significantly increased postoperative bleeding complications. Patients receiving ketorolac had a 17% bleeding rate compared to 4.4% with traditional opioids, suggesting avoidance is prudent.

Area of Science:

  • Otolaryngology
  • Anesthesiology
  • Pharmacology

Background:

  • Posttonsillectomy bleeding is a significant concern.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are sometimes used for pain management.
  • Ketorolac tromethamine is a potent NSAID.

Purpose of the Study:

  • To evaluate the incidence of posttonsillectomy bleeding.
  • To assess the association between intraoperative ketorolac tromethamine and bleeding complications.

Main Methods:

  • Retrospective analysis of 311 patients undergoing tonsillectomy.
  • Comparison of bleeding rates between patients receiving ketorolac and those receiving traditional opioid analgesics.
  • Data collected from an academic tertiary care center over 18 months.

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Main Results:

  • Fifty-eight patients received intraoperative ketorolac, with a 17% postoperative bleeding rate.
  • The remaining 253 patients received traditional opioids, experiencing a 4.4% bleeding rate.
  • A significantly higher incidence of bleeding complications was observed in the ketorolac group.

Conclusions:

  • Intraoperative ketorolac tromethamine is associated with an increased risk of posttonsillectomy bleeding.
  • The use of ketorolac in tonsillectomy patients should be reconsidered.
  • Further controlled studies are recommended to confirm these findings.