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Safety of intravenous use of ketorolac in infants following cardiothoracic surgery

Published online by Cambridge University Press:  12 January 2009

Tamara N. Dawkins ,
Cynthia A. Barclay ,
Rhonda L. Gardiner  and
Catherine D. Krawczeski
Tamara N. Dawkins
Affiliation:
Division of Pharmacy, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio Department of Pharmacy, Medical University of South Carolina, Charleston, South Carolina, United States of America
Cynthia A. Barclay*
Affiliation:
Division of Pharmacy, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Rhonda L. Gardiner
Affiliation:
Division of Pharmacy, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Catherine D. Krawczeski
Affiliation:
Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
*
Correspondence to: Cynthia A. Barclay, Pharm.D., Division of Pharmacy, MLC #1011, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, Ohio 45229, USA. Tel: 513-636-8247; Fax: 513-636-4600; E-mail: Cynthia.Barclay@cchmc.org
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Abstract

Objectives

To evaluate the impact of intravenous ketorolac on renal function and haematologic values in patients less than six months old following cardiothoracic surgery.

Background

Ketorolac is a potent nonsteroidal anti-inflammatory drug indicated for short term management of moderate to severe post-operative pain. Little data is available related to its safety in infants less than six months of age.

Methods

This was a retrospective, case-control chart review of 19 patients aged less than six months of age with biventricular circulations who received intravenous ketorolac following cardiothoracic surgery. They were compared with 19 age-matched control patients. Those with functionally univentricular anatomy were excluded due to their higher risk for renal impairment following surgery. Student’s t-test was used to compare the incidence of renal impairment and haematologic complications between the groups, as well as the number of analgesic doses administered. Charts were reviewed for number of blood transfusions.

Results

Patients receiving intravenous ketorolac had no statistically significant changes in pre-operative versus post-treatment renal function or haematologic effects compared to the control group. No statistically significant differences were detected for number of post-operative blood transfusions or additional analgesic administration between groups.

Conclusions

Intravenous ketorolac appears to be safe when used in infants less than six months of age with biventricular circulations following cardiothoracic surgery. Ketorolac as used in these patients does not decrease the use of standard analgesic therapy.

Keywords

Pediatricscardiologyadverse drug reactions
Type
Original Article
Information
Cardiology in the Young , Volume 19 , Issue 1 , February 2009 , pp. 105 - 108
Copyright
Copyright © Cambridge University Press 2009

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References

1. Forrest, JB. Defining the role of nonsteroidal anti-inflammatory drugs (NSAIDs) in postoperative pain management. S Afr J Anaesth Analg 1996; 2: 8–13.Google Scholar
2. Alexander, JI, Hill, RG. Postoperative pain control. Blackwell Scientific Publications, Oxford, 1987.Google Scholar
3. Bhaft-Melia, V, Rosen, DA. Management of acute pain in children. Clin Pharm 1991; 10: 667–685.Google Scholar
4. Maunuksela, E. Pain treatment in infants and children. Acta Anaesthesiol Scand 1991; 35 (Suppl): 157–159.Google Scholar
5. Valley, RD, Bailey, AG. Caudal morphine for postoperative analgesia in infants and children: a report of 138 cases. Anesth Analg 1991; 72: 120–124.CrossRefGoogle ScholarPubMed
6. Johnston, CC, Abbott, FV, Gray-Donald, K, Jeans, ME. A survey of pain in hospitalized patients aged 4-14 years. Clin J Pain 1992; 8: 154–163.CrossRefGoogle ScholarPubMed
7. Cummings, EA, Reid, GT, Finley, GA, McGrath, PJ, Ritchie, JA. Prevalence and source of pain in pediatric inpatients. Pain 1996; 68: 25–31.CrossRefGoogle ScholarPubMed
8. Abraxis Pharmaceutical Products. Ketorolac tromethamine injection, USP package insert. Schaumburg, IL; 2006.Google Scholar
9. Kokki, H. Nonsteroidal anti-inflammatory drugs for postoperative pain. Paediatr Drugs 2003; 5: 103–123.CrossRefGoogle ScholarPubMed
10. Moffett, B, Wann, T, Carberry, K, Mott, A. Safety of ketorolac in neonates and infants after cardiac surgery. Paediatr Anaesth 2006; 16: 424–428.CrossRefGoogle ScholarPubMed
11. Gupta, A, Daggett, C, Drant, S, Rivero, N, Lewis, A. Prospective randomized trial of ketorolac after congenital heart surgery. J Cardiothorac Vasc Anesth 2004; 18: 454–457.CrossRefGoogle ScholarPubMed