Postoperative hemorrhage after tonsillectomy: Use of ketorolac tromethamine

Recent reports have associated an increased incidence of bleeding after ton sillectomy with the perioperative use of ketorolac tromethamine. To review this association, we examined the hospital and office records of 310 pediat ric patients who underwent tonsillectomy with or without adenoidectomy at o ur institution during a 2-year period. Of these patients, 213 received keto rolac administered as a single dose at the conclusion of the procedure. The remaining 97 patients did not receive ketorolac. The frequency of postoper ative hemorrhage was not found to differ significantly between these 2 grou ps (2.3% vs. 3.1% respectively P = 0.71). Furthermore, the average time to discharge after surgery was significantly shorter in those patients who rec eived ketorolac than in those who did not (8.5 hours vs. 12.5 hours, respec tively, P < 0.0001). The frequency of overnight hospital stays was also sig nificantly lower in those patients who received ketorolac (16.0% vs. 31.6%, respectively, P < 0.01). Concern over the potential for increased hemorrha ge after tonsillectomy has led several authors to caution against the use o f ketorolac in this setting. In our study, however, the use of ketorolac wa s not found to increase the incidence of posttonsillectomy hemorrhage and f urthermore was associated with a significant decrease in the length of hosp ital stay as well as a decreased likelihood of overnight hospital stay afte r surgery.