Use of ketorolac tromethamine in children undergoing scoliosis surgery: an analysis of complications

Vitale, Michael G; Choe, Julie C; Hwang, Matthew W; Bauer, Rebecca M; Hyman, Joshua E; Lee, Francis Y; Roye, David P

« Previous Next »The Spine Journal
Volume 3, Issue 1 , Pages 55-62, January 2003

Use of ketorolac tromethamine in children undergoing scoliosis surgery:☆☆☆

an analysis of complications

Michael G Vitale, MD, MPH
- Corresponding author. 600 West 168th Street, 7th Floor, New York, NY 10032, USA. Tel.: (212) 305-5028; fax: (212) 305-4256.
- International Center for Health Outcomes and Innovative Research, College of Physicians and Surgeons, and the Josepth L. Mailman School of Public Health, Columbia University and New York Presbyterian Hospital, 600 West 168th Street, 7th Floor, New York, NY 10032, USA
- Division of Pediatric Orthopedics, Department of Orthopedic Surgery, Columbia University College of Physicians and Surgeons, 3959 Broadway, 8th Floor North, New York, NY 10032, USA
Julie C Choe, MPH
- International Center for Health Outcomes and Innovative Research, College of Physicians and Surgeons, and the Josepth L. Mailman School of Public Health, Columbia University and New York Presbyterian Hospital, 600 West 168th Street, 7th Floor, New York, NY 10032, USA
Matthew W Hwang, MD, MPH
- Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA
Rebecca M Bauer, MPH
- Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA
Joshua E Hyman, MD
- Division of Pediatric Orthopedics, Department of Orthopedic Surgery, Columbia University College of Physicians and Surgeons, 3959 Broadway, 8th Floor North, New York, NY 10032, USA
Francis Y Lee, MD, PhD
- Division of Pediatric Orthopedics, Department of Orthopedic Surgery, Columbia University College of Physicians and Surgeons, 3959 Broadway, 8th Floor North, New York, NY 10032, USA
David P Roye Jr., MD
- Division of Pediatric Orthopedics, Department of Orthopedic Surgery, Columbia University College of Physicians and Surgeons, 3959 Broadway, 8th Floor North, New York, NY 10032, USA

Received 1 March 2002; accepted 20 May 2002.

Abstract

Background context: Ketorolac Tromethamine (ketorolac) is a nonsteroidal anti-inflammatory drug (NSAID) with proven efficacy in decreasing postoperative pain in various surgical settings, including the treatment of spine deformities. However, some studies have raised questions regarding the potential side effects of this agent, such as increased bleeding and inhibition of bony fusion.

Purpose: This study was conducted to determine whether there is any association between the use of ketorolac and postoperative complications in a group of children who underwent scoliosis surgery.

Study design/setting: This is a retrospective review of a group of children who underwent spinal fusion between 1989 to 1999 at our institution.

Patient sample: Data on a total of 208 children were analyzed in this study. Sixty received ketorolac and 148 did not.

Outcome measures: Postoperative transfusion and reoperation rates were the two main outcome measures of interest.

Methods: A retrospective review of 208 children who underwent scoliosis surgery was conducted, with a focus on ketorolac use. Univariate analysis and logistic regression were used to quantify the determinants of postoperative complications.

Results: Our analyses detected no significant differences in a broad range of socioclinical variables between the two patient groups, including age at surgery, gender, type of scoliosis, surgical approach, use of erythropoietin, levels of curvature and degree of curvature. Analysis of complication rates focusing on postoperative transfusion and revision surgery showed that there were no significant differences between the two groups.

Conclusions: In this retrospective study of 208 children undergoing spine surgery, postoperative use of ketorolac did not significantly increase complications, including transfusion and reoperation.

Keywords: Ketorolac tromethamine, Ketorolac, NSAID, Scoliosis, Children, Complications, Side effects, Transfusion, Revision surgery