%0 Journal Article
%T Does perioperative ketorolac increase bleeding risk after intracapsular tonsillectomy?
%A Kolb CM
%A Jain N
%A Schillinger K
%A Born K
%A Banker K
%A Aaronson NL
%A Nardone HC
%J Int J Pediatr Otorhinolaryngol
%V 147
%N 0
%D Aug 2021
%M 34052574
%F 1.626
%R 10.1016/j.ijporl.2021.110781
%X <B>OBJECTIVE: </B>Conflicting evidence exists regarding the post-tonsillectomy bleed risk associated with perioperative ketorolac use in the pediatric population. Surgical technique for tonsillectomy can further confound this risk.<BR><B>OBJECTIVE: </B>The primary objective was to retrospectively quantify the post-tonsillectomy bleed rate after single-dose administration of ketorolac in pediatric patients following intracapsular tonsillectomy. The secondary objective was to determine if age, sex, body mass index, medical comorbidities, and indication for surgery increased post-tonsillectomy bleed risk.<BR><B>METHODS: </B>Retrospective cohort study of 1920 children who underwent intracapsular tonsillectomies between January 2017 and December 2018.<BR><B>METHODS: </B>This study was completed at a tertiary-care pediatric referral center.<BR><B>METHODS: </B>1920 children who underwent intracapsular tonsillectomies between January 2017 and December 2018 at a single tertiary-care children's hospital.<BR><B>UNASSIGNED: </B>Patients were divided into two cohorts: 1458 patients (75.9%) received ketorolac (K+), and 462 (24.1%) did not (NK). Age, sex, body mass index, comorbidities, and indication for surgery also were evaluated for association with post-tonsillectomy bleed risk.<BR><B>UNASSIGNED: </B>Primary study outcome for both cohorts was post-tonsillectomy hemorrhage requiring operative intervention.<BR><B>RESULTS: </B>1920 study participants were included with an average age of 6.5 years; 51.5% of participants were males; and, 63.9% were white. Overall, the postoperative bleeding rate was 1.5%. However, there was no significant difference when comparing bleeding rates for the ketorolac group and the non-keterolac group (1.4%-1.7%; P = .82) Age, chronic tonsillitis, higher body mass index Z-scores, attention-deficit/hyperactivity disorder, and behavioral diagnoses were statistically significant risk factors for post-tonsillectomy hemorrhage.<BR><B>CONCLUSIONS: </B>Single-dose postoperative ketorolac does not appear to be associated with increased risk of post-tonsillectomy bleed in pediatric patients undergoing intracapsular tonsillectomy. Providers should not avoid using ketorolac in patients undergoing intracapsular tonsillectomy due to concerns over bleeding risk.