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- Title
Perioperative Ketorolac Increases Post-Tonsillectomy Hemorrhage in Adults But Not Children.
- Authors
Chan, Dylan K.; Parikh, Sanjay R.
- Abstract
Objectives/Hypothesis: To evaluate the risk of post-tonsillectomy hemorrhage associated with perioperative ketorolac use. Study Design: Systematic review and meta-analysis of primary articles reporting individual-level post-tonsillectomy hemorrhage rates in subjects receiving perioperative ketorolac and matched controls. Retrospective and prospective studies were both included. Methods: PubMed search was performed for "[ketorolac OR toradol] AND tonsillectomy." Articles fulfilling inclusion criteria were subjected to meta-analysis to determine summary relative risk (RR). Results: Adults are at five times increased risk for post-tonsillectomy hemorrhage with ketorolac use (RR: 5.64; 95% confidence interval [CI]: 2.08-15.27; P<.001). In contrast, children under 18 are not at statistically significantly increased risk (RR: 1.39; 95% CI: 0.84-2.30; P=.20). Both retrospective and prospective studies yield consistent findings. There is no association of RR with pre- or postoperative administration of ketorolac. Conclusions: Ketorolac can be used safely in children, but is associated with a five-fold increased bleeding risk in adults.
- Subjects
HEMORRHAGE complications; KETOROLAC; TONSILLECTOMY; PERIOPERATIVE care; SLEEP apnea syndromes; HEALTH of adults; THERAPEUTICS
- Publication
Laryngoscope, 2014, Vol 124, Issue 8, p1789
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1002/lary.24555