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- Title
Safety and Efficacy of Single-Dose Ketorolac for Postoperative Pain Management After Primary Palatoplasty: A Prospective Cohort Study With Historical Controls.
- Authors
Stein, Jason R.; Mantilla-Rivas, Esperanza; Aivaz, Marudeen; Rana, Md Sohel; Mamidi, Ishwarya Shradha; Ichiuji, Brynne A.; Manrique, Monica; Rogers, Gary F.; Finkel, Julia C.; Oh, Albert K.
- Abstract
Objective: To analyze safety and efficacy of single-dose ketorolac after primary palatoplasty (PP). Design: Consecutive cohort of patients undergoing PP, comparing to historical controls. Setting: A large academic children's hospital. Patients, Participants: A consecutive cohort of 111 patients undergoing PP (study n = 47) compared to historical controls (n = 64). Interventions: All patients received intraoperative acetaminophen, dexmedetomidine, and opioids while the study group received an additional single dose of ketorolac (0.5 mg/kg) at the conclusion of PP. Main Outcome Measures: Safety of ketorolac was measured by significant bleeding complications and need for supplementary oxygen. Efficacy was assessed through bleeding, Face Legs Activity Cry Consolability (FLACC) scale, and opioid dose. Results: Length of stay was similar for both groups (control group 38.5 hours [95% CI: 3.6-43.3] versus study group 37.6 hours [95% CI: 31.3-44.0], P =.84). There were no significant differences in all postoperative FLACC scales. The mean dose of opioid rescue medication measured as morphine milligram equivalents did not differ between groups (P =.56). Significant postoperative hemorrhage was not observed. Conclusions: This is the first prospective study to evaluate the safety and efficacy of single-dose ketorolac after PP. Although lack of standardization between study and historical control groups may have precluded observation of an analgesic benefit, analysis demonstrated a single dose of ketorolac after PP is safe. Further investigations with more patients and different postoperative regimens may clarify the role of ketorolac in improving pain after PP.
- Subjects
DRUG efficacy; LENGTH of stay in hospitals; STATISTICAL power analysis; CONFIDENCE intervals; EFFECT sizes (Statistics); CLEFT palate; HEALTH outcome assessment; FISHER exact test; CLEFT lip; MATHEMATICAL variables; T-test (Statistics); CHI-squared test; DESCRIPTIVE statistics; DATA analysis software; POSTOPERATIVE pain; KETOROLAC; PAIN management; LONGITUDINAL method; EVALUATION
- Publication
Cleft Palate Craniofacial Journal, 2022, Vol 59, Issue 4, p505
- ISSN
1055-6656
- Publication type
Article
- DOI
10.1177/10556656211012864