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Perioperative ketorolac does not elevate bleeding risk after tonsillectomy

Perioperative ketorolac does not elevate bleeding risk after tonsillectomy Perioperative ketorolac does not elevate bleeding risk after tonsillectomy
Perioperative ketorolac does not elevate bleeding risk after tonsillectomy Perioperative ketorolac does not elevate bleeding risk after tonsillectomy

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Clinicians should not avoid ketorolac use in individuals undergoing tonsillectomy due to concerns over the bleeding risk.

In pediatrics who underwent intracapsular tonsillectomy, a single dose of postsurgery ketorolac does not seem to be linked with a raised risk of post-tonsillectomy bleed, as per the findings of a study published in The International Journal of Pediatric Otorhinolaryngology. 

Caroline M Kolb et al. undertook a retrospective cohort study for retrospectively quantifying the post-tonsillectomy bleed rate following single-dose administration of ketorolac, an nonsteroidal anti-inflammatory drug (NSAID) for tonsillectomy. The investigators also examined whether the post-tonsillectomy bleeding risk is elevated by body mass index, age, medical comorbidities, indication for surgery, and gender.

The study recruited 1920 children (average age 6.5 years; 51.5% males; 63.9% were white) and segregated them into 2 groups: (i) Group  receiving ketorolac (75.9%, n=1458), and (ii) Group not receiving ketorolac (24.1%, n=462). The post-tonsillectomy hemorrhage needing operative intervention was the major endpoint of the study.

The postsurgery bleeding rate was reported to be 1.5%. But, during the comparison of ketorolac and non-ketorolac groups, no profound differences were noted in terms of post-tonsillectomy bleeding rate, as illustrated in Table 1:


For post-tonsillectomy hemorrhage, the pivotal risk factors were  higher body mass index Z-scores, age, behavioral diagnoses, chronic tonsillitis, and attention-deficit/hyperactivity disorder. Thus, ketorolac can minimize postoperative pain without magnifying post-tonsillectomy bleeding risk.


Source:

The International Journal of Pediatric Otorhinolaryngology

Article:

Does perioperative ketorolac increase bleeding risk after intracapsular tonsillectomy?

Authors:

Caroline M Kolb et al.

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