title: Effect of ketorolac tromethamine (Toradol) on ecchymosis following anterior cruciate ligament reconstruction.
abstract: This article describes a study that assesses whether patients who received ketorolac tromethamine (Toradol; Syntex Research, Palo Alto, California) during knee surgery had an increased tendency to develop ecchymosis in the lower limb versus patients who did not receive ketorolac tromethamine. Sixty-four patients who underwent anterior cruciate ligament (ACL) surgery were divided randomly into three groups: patients who received Toradol at tourniquet inflation (TorTourn) at the end of surgery (TorEnd), or not at all (TorNone). None of the patients exhibited abnormal preoperative bleeding times. One week postsurgery, patients were evaluated photographically for ecchymosis between the hip and malleoli of the surgical limb. Ecchymotic areas between the hip and malleoli were traced around their borders with a black marker. Three photographs of each surgical knee were taken: posterior, anterolateral, and anteromedial views. Each patient's photos then were scanned into a computer and the amount of encircled (ecchymotic) surface area and the total surface area of the limb were calculated. For each view, the ecchymotic surface area was divided by the total surface area to obtain a percentage of ecchymosis on that view. The percentages for the three views were added to obtain a single score for each patient. The mean ecchymotic surface area score was 21.9 +/- 31% for the TorTourn group, 27.5 +/- 25.5% for the TorEnd group, and 30.3 +/- 36.4% for the TorNone group. There was no significant difference in the ecchymotic surface area among the groups. This study suggests that ketorolac tromethamine does not affect the amount of ecchymosis that occurs following knee surgery.
authors.affiliation: Joe W. King Orthopedic Institute, Houston, Texas 77030-4509.
authors.forename: J C
authors.initials: JC
authors.lastname: Milne
authors.forename: J A
authors.initials: JA
authors.lastname: Russell
authors.forename: G W
authors.initials: GW
authors.lastname: Woods
authors.forename: M D
authors.initials: MD
authors.lastname: Dalton
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001830:Body Surface Area; D004338:Drug Combinations; D004438:Ecchymosis / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D020911:Ketorolac Tromethamine; D007868:Leg Dermatoses / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D017847:Patellar Ligament / Q000601:surgery; D010781:Photography; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D015203:Reproducibility of Results; D014046:Tolmetin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014111:Tourniquets / Q000009:adverse effects; D014325:Tromethamine / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004338:Drug Combinations; D010975:Platelet Aggregation Inhibitors; D014325:Tromethamine; D020911:Ketorolac Tromethamine; D014046:Tolmetin