Ketorolac as an analgesic agent for infants and children after cardiac surgery: safety profile and appropriate patient selection.
Ketorolac has been used safely as an analgesic agent for children following cardiac surgery in selected populations. Controversy exists among institutions about the risks involved with this medication in this patient group. This article reviews the current literature regarding the safety of ketorolac for postoperative pain management in children after cardiac surgery. Specifically, concerns about renal dysfunction and increased bleeding risk are addressed. Additionally, the article details pharmacokinetics and potential benefits of ketorolac, such as its opioid-sparing effect. The literature reflects that the use of this medication is not well studied in certain pediatric cardiac patients such as neonates and those with single-ventricle physiology, and the safety of this medication in regards to these special populations is reviewed. In conclusion, ketorolac can be used in specific pediatric patients after cardiac surgery with minimal risk of bleeding or renal dysfunction with appropriate dosing and duration of use.
Meredith K. Jalkut is Pediatric Nurse Practitioner, Children's Hospital of Philadelphia, 1519 S Clarion St, Philadelphia, PA 19147 (meredith.jalkut@gmail.com).
Meredith K
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Jalkut
D000700:Analgesics / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007223:Infant; D020910:Ketorolac / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D018579:Patient Selection
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D020910:Ketorolac