Archives of Critical Care Medicine

Published by: Kowsar

Efficacy and Safety of Ketorolac for Pain Management After Congenital Heart Surgery: A Comparison to Paracetamol

Shahram Amini 1 , Ehsan Mahdavi 1 , Ghasem Soltani 1 , * , Nahid Zirak 1 , Mohammad Abbasi Tashnizi 2 , Vida Vakili 3 and Farideh Golhasani 1
Authors Information
1 Cardiac Anesthesia Research Center, Department of Anesthesiology and Critical Care, Mashhad University of Medical Sciences, Mashhad, IR Iran
2 Department of Cardiac Surgery, Mashhad University of Medical Sciences, Mashhad, IR Iran
3 Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
Article information
  • Archives of Critical Care Medicine: November 2016, 1 (4); e8278
  • Published Online: November 28, 2015
  • Article Type: Research Article
  • Received: September 30, 2015
  • Accepted: November 14, 2015
  • DOI: 10.17795/accm-8278

To Cite: Amini S, Mahdavi E, Soltani G, Zirak N, Abbasi Tashnizi M, et al. Efficacy and Safety of Ketorolac for Pain Management After Congenital Heart Surgery: A Comparison to Paracetamol, Arch Crit Care Med. 2016 ; 1(4):e8278. doi: 10.17795/accm-8278.

Copyright © 2015, Shahid Beheshti University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Bruce EA, Howard RF, Franck LS. Chest drain removal pain and its management: a literature review. J Clin Nurs. 2006; 15(2): 145-54[DOI][PubMed]
  • 2. Foruzannia K, Moshtaghiun H, Mirhosseini H, Abdolahi.M H, Golzar A. Comparative effects of tramadol, indomethacin, and acetaminophen in controlling pain after coronary artery bypass surgery. Anaesthesiol Intens Care J. 2009; 30(61): 32-40
  • 3. Baley K, Michalov K, Kossick MA, McDowell M. Intravenous acetaminophen and intravenous ketorolac for management of pediatric surgical pain: a literature review. AANA J. 2014; 82(1): 53-64[PubMed]
  • 4. Richardson MD, Palmeri NO, Williams SA, Torok MR, O'Neill BR, Handler MH, et al. Routine perioperative ketorolac administration is not associated with hemorrhage in pediatric neurosurgery patients. J Neurosurg Pediatr. 2016; 17(1): 107-15[DOI][PubMed]
  • 5. Chan DK, Parikh SR. Perioperative ketorolac increases post-tonsillectomy hemorrhage in adults but not children. Laryngoscope. 2014; 124(8): 1789-93[DOI][PubMed]
  • 6. Sukhtankar DD, Lee H, Rice KC, Ko MC. Differential effects of opioid-related ligands and NSAIDs in nonhuman primate models of acute and inflammatory pain. Psychopharmacology (Berl). 2014; 231(7): 1377-87[DOI][PubMed]
  • 7. Holdgate A, Asha S, Craig J, Thompson J. Comparison of a verbal numeric rating scale with the visual analogue scale for the measurement of acute pain. Emerg Med (Fremantle). 2003; 15(5-6): 441-6[PubMed]
  • 8. Thagaard KS, Jensen HH, Raeder J. Analgesic and antiemetic effect of ketorolac vs. betamethasone or dexamethasone after ambulatory surgery. Acta Anaesthesiol Scand. 2007; 51(3): 271-7[DOI][PubMed]
  • 9. Jalkut MK. Ketorolac as an analgesic agent for infants and children after cardiac surgery: safety profile and appropriate patient selection. AACN Adv Crit Care. 2014; 25(1): 23-30[DOI][PubMed]
  • 10. Inoue M, Caldarone CA, Frndova H, Cox PN, Ito S, Taddio A, et al. Safety and efficacy of ketorolac in children after cardiac surgery. Intensive Care Med. 2009; 35(9): 1584-92[DOI][PubMed]
  • 11. Dawkins TN, Barclay CA, Gardiner RL, Krawczeski CD. Safety of intravenous use of ketorolac in infants following cardiothoracic surgery. Cardiol Young. 2009; 19(1): 105-8[DOI][PubMed]
  • 12. Lee SY, Lee WH, Lee EH, Han KC, Ko YK. The effects of paracetamol, ketorolac, and paracetamol plus morphine on pain control after thyroidectomy. Korean J Pain. 2010; 23(2): 124-30[DOI][PubMed]
  • 13. Anand A, Sprenker CJ, Karlnoski R, Norman J, Miladinovic B, Wilburn B, et al. Intravenous acetaminophen vs. ketorolac for postoperative analgesia after ambulatory parathyroidectomy. Scandinavian J Pain. 2013; 4(4): 249-53[DOI]
  • 14. Burd RS, Tobias JD. Ketorolac for pain management after abdominal surgical procedures in infants. South Med J. 2002; 95(3): 331-3[PubMed]
  • 15. Chauhan RD, Idom CB, Noe HN. Safety of ketorolac in the pediatric population after ureteroneocystostomy. J Urol. 2001; 166(5): 1873-5[PubMed]
  • 16. Shekari M. The effect of paracetamol, morphine intravenously and intravenous ketorolac control of renal colic pain in patients presenting to the emergency room [in Pesian]. Bandar abbas univ med sci. 2014;
  • 17. Iorno V, Landi L, Di Pasquale R, Cicenia S, Moschini V. Comparison of intravenous ketorolac with or without paracetamol in postoperative pain control following ambulatory surgery. Curr Med Res Opin. 2013; 29(12): 1685-90[DOI][PubMed]
  • 18. Lynn AM, Bradford H, Kantor ED, Andrew M, Vicini P, Anderson GD. Ketorolac tromethamine: stereo-specific pharmacokinetics and single-dose use in postoperative infants aged 2-6 months. Paediatr Anaesth. 2011; 21(3): 325-34[DOI][PubMed]
  • 19. Gupta A, Daggett C, Drant S, Rivero N, Lewis A. Prospective randomized trial of ketorolac after congenital heart surgery. J Cardiothorac Vasc Anesth. 2004; 18(4): 454-7[PubMed]
  • 20. Bosek V, Smith DB, Endicott J, Klotch D, Ridley M. Comparison of intravenous ketorolac and alfentanil as supplements to propofol anesthesia for diagnostic panendoscopy. J Clin Anesth. 1995; 7(1): 40-3[PubMed]
  • 21. Moffett BS, Cabrera A. Ketorolac-associated renal morbidity: risk factors in cardiac surgical infants. Cardiol Young. 2013; 23(5): 752-4[DOI][PubMed]
  • 22. Moffett BS, Wann TI, Carberry KE, Mott AR. Safety of ketorolac in neonates and infants after cardiac surgery. Paediatr Anaesth. 2006; 16(4): 424-8[DOI][PubMed]
  • 23. Gupta A, Daggett C, Ludwick J, Wells W, Lewis A. Ketorolac after congenital heart surgery: does it increase the risk of significant bleeding complications? Paediatr Anaesth. 2005; 15(2): 139-42[DOI][PubMed]
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments