Early Utilization of Ketorolac in Cleft Palate Repair

Abstract

Objective To determine the effect of ketorolac on opiate requirement and hospital length of stay after palatoplasty. Design This was a retrospective chart review. Setting This study was completed at an urban tertiary medical center. Patients Those who underwent palatoplasty with a pediatric otolaryngologist between 2010-2020. Interventions Incorporation of standing Ketorolac into the immediate post-operative pain regimen. Main outcome measures T-test analysis was performed to determine whether initiation of ketorolac within 24 h post-palatoplasty was correlated with shorter length hospitalization or reduced opiate requirement. Results A total of 55 pediatric subjects (49.1% female) were included in this study. Average age at time of surgery was 13 months (range 9.9-33.9 months). On two tailed t-test, use of ketorolac within the first 24 h after palatoplasty was associated with shorter length of stay (mean of 1.68 vs 2.57 days, t = 2.58, P = .01) and lower total opiate dosage during hospitalization (mean of 2.8 vs 9.16 morphine milligram equivalents, t = 3.37, P = .001). Conclusions Among patients undergoing palatoplasty, there is a significant relationship between the early utilization of ketorolac and decreased length of hospitalization as well as decreased opiate requirement. This has important consequences to help improve pain control with reduced opiates requirement as well as length of stay. Future prospective studies can help elicit the causative effect of Ketorolac on these parameters and can investigate whether use of Ketorolac has an effect on long term recovery and post-discharge opiate requirements as well.