Ketorolac is a nonsteroidal antiinflammatory drug that has been used as a postoperative analgesic since its introduction in the US in 1990. Although hemorrhagic side effects secondary to its use have been consistently described in the medical literature, its attendant complications have been commonly unappreciated by the medical profession. Two catastrophic, near-fatal, hemorrhagic postoperative events are described in which the use of ketorolac was unquestionably contraindicated.
Get full access to this article
View all access options for this article.
References
1.
Gunter JB, Varughese AM, Harrington JF, et al: Recovery and complications after tonsillectomy in children: A comparison of ketorolac and morphine. Anesth Analg81:1136-1141, 1995.
2.
Conrad KA, Fagan TC, Mackie MJ, et al: Effects of ketorolac tromethamine on hemostasis in volunteers . Clin Pharmacol Ther43:542-546, 1988.
3.
Strom BL, Berlin JA, Kinman JL, et al: Parenteral ketorolac and risk of gastrointestinal and operative site bleeding. JAMA275:376-382, 1996.
4.
Colman RW, Hirsh J., Marder VJ, et al: Hemostasis and Thrombosis. Philadelphia: Lippincott, 1987.
5.
Dordoni PL, Della Ventura M., Steffanelli A., et al: Effect of ketorolac, ketoprofen and nefopam on platelet function . Anesthesia49:1046-1049, 1994 .
6.
Thwaites BK, Nigus DB, Booska GW, et al: Intravenous ketorolac tromethamine does not worsen platelet function during knee arthroscopy under general anesthesia. Anesth Analg81:119-124, 1995.
7.
Zuccala G., Pahor M., Landi F., et al: Use of calcium antagonists and need for perioperative transfusion in older patients with hip fracture: Observational study. Br Med J314:643-644, 1997.
8.
Feldman HI, Kinman JL, Berlin JA, et al: Parenteral ketorolac: The risk for acute renal failure. Ann Intern Med126:193-199, 1997.
9.
Buck ML, Norwood VF: Ketorolac-induced acute renal failure in a previously healthy adolescent. Pediatrics98:294-296, 1996.
10.
Gallagher JE , Blauth J., Fornadley JA: Perioperative ketorolac tromethamine and postoperative hemorrhage in cases of tonsillectomy and adenoidectomy. Laryngoscope105:606-609, 1995.
11.
Rusy LM, Houck CS, Sullivan LJ, et al: A double-blind evaluation of ketorolac tromethamine versus acetaminophen in pediatric tonsillectomy: Analgesia and bleeding. Anesth Analg80:226-229, 1995.
12.
Physicians' Desk Reference. Montvale, NJ , Medical Economics, 1997, pp 2319-2321.
