title: Ketorolac does not reduce effectiveness of pleurodesis in pediatric patients with spontaneous pneumothorax.
abstract: OBJECTIVE
  Antiinflammatory medications are thought to reduce the effectiveness of pleurodesis performed for the treatment of spontaneous pneumothorax. We reviewed our experience with children undergoing video-assisted thorascopic surgery (VATS) with pleurodesis for pneumothorax to determine if ketorolac administration influences patient outcomes.
  
  
  METHODS
  A retrospective review of patients who underwent VATS pleurodesis for spontaneous pneumothorax from 2009 to 2013 at a pediatric hospital was performed. Length of stay, radiographic pneumothorax resolution prior to discharge, and ipsilateral recurrence rates were compared in patients who did and did not receive perioperative ketorolac.
  
  
  RESULTS
  Over a 50-month period, 51 patients underwent VATS with mechanical pleurodesis for spontaneous pneumothorax. The average age was 15.5years, and 76% were male. Ketorolac was administered to 26/51 patients. There were no differences in average length of stay (11.3 vs 10.9days, p=0.36), incidence of residual pneumothorax at discharge (22/41 vs 19/41, p=0.48), or ipsilateral recurrence (5/10 vs 5/10, p=1).
  
  
  CONCLUSIONS
  Despite the intrinsic antiinflammatory properties of ketorolac, our data suggests that its use for patients undergoing pleurodesis for spontaneous pneumothorax does not detrimentally influence the outcomes of surgery. Therefore, we conclude that ketorolac can be used for pain control in this population. Large-scale studies are warranted to validate these findings.
authors.affiliation: Department of Surgery, Naval Medical Center San Diego, San Diego, CA, USA; Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, CA, USA. Electronic address: eliel.lizardo@gmail.com.
authors.forename: Radhames E
authors.initials: RE
authors.lastname: Lizardo
authors.affiliation: Department of Surgery, University of California San Diego, La Jolla, CA, USA; Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, CA, USA.
authors.forename: Simone
authors.initials: S
authors.lastname: Langness
authors.affiliation: Department of Surgery, University of California San Diego, La Jolla, CA, USA; Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, CA, USA.
authors.forename: Katherine P
authors.initials: KP
authors.lastname: Davenport
authors.affiliation: Department of Surgery, University of California San Diego, La Jolla, CA, USA; Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, CA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Kling
authors.affiliation: Department of Surgery, University of California San Diego, La Jolla, CA, USA; Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, CA, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Fairbanks
authors.affiliation: Department of Surgery, University of California San Diego, La Jolla, CA, USA; Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, CA, USA.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Bickler
authors.affiliation: Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
authors.forename: Julia
authors.initials: J
authors.lastname: Grabowski
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000009:adverse effects* / Q000627:therapeutic use; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D018700:Pleurodesis; D011030:Pneumothorax / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D020910:Ketorolac
keywords: Children; Ketorolac; Outcomes; Pleurodesis; Pneumothorax; Surgery