Perioperative ketorolac analgesia for patients undergoing adenoidectomy: A retrospective analysis

Abstract

Objective: To analyze a case series of adenoidectomy patients who received interoperative ketorolac. To also analyze a case series of adenoidectomy patients who did not receive ketorolac.

Method: This is a retrospective chart review, analyzing 429 patients aged 2-18 years of age who underwent adenoidectomy without tonsillectomy. Data collected included patient age at surgery, gender, secondary procedures, medication, post-operative care, post-operative bleeding, and bleeding, and medical history. Statistical analysis was performed using JMP ® Pro, Version 14.0.0. SAS Institute Inc., Cary, NC, 1989-2019. The primary study outcomes were returning to the operating room prior to discharge from hospital or any return to the emergency department within 4 weeks of the surgery with active bleeding.

Results: The average age on the day of surgery for those that received ketorolac was 3.35 years and 62% (n = 61) were male. Of the 98 patients who received interoperative ketorolac, none had a bleeding episode. The remaining 331 adenoidectomy patients who did not receive ketorolac also had 0 bleeds. The numbers of patients are insufficient to support an equivalence study.

Conclusions: Bleeds after adenoidectomy are scarce, with or without ketorolac, and thus it is difficult to detect an increase in complications. A much larger study would be necessary to generate enough statistical power. There are no findings in this study that pre-empt further investigation into whether ketorolac truly increases perioperative adenoidectomy bleed rates in medically eligible patients.

Keywords: Adenoidectomy; Bleeding; Ketorolac; Toradol.