Safety of intravenous use of ketorolac in infants following cardiothoracic surgery

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 postoperative 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.