Key result
Perioperative continuous infusion of ketorolac did not increase blood loss under either general or spinal anesthesia, although it impaired platelet function under spinal anesthesia.
Why the study?
Does perioperative continuous infusion of ketorolac affect platelet function and blood loss in patients under general or spinal anesthesia?
RCT (n=45)
Does perioperative continuous infusion of ketorolac affect platelet function and blood loss in patients under general or spinal anesthesia?
Perioperative continuous infusion of ketorolac does not increase blood loss under general or spinal anesthesia, despite some impairment of platelet function under spinal anesthesia.
Answers are grounded in this paper and cite their sources.
May support perioperative ketorolac use without bleeding concern; leaves open clinical relevance of platelet impairment under spinal anesthesia.
Background: The purposes of this study were to investigate the effects of perioperative continuous infusion of ketorolac on platelet function and blood loss under either general or spinal anesthesia. Methods: The patients under general anesthesia received saline 1 ml (C group) or ketorolac 30 mg (GK group) intravenously 10 min before skin incision, followed, respectively, by a continuous infusion of saline (4 ml/h) or ketorolac (2.5 mg/h) for 24 h. The patients under spinal anesthesia (SK group) received the same amount of ketorolac as that of the GK group. Blood loss was collected and measured at 3 h, 6 h, 12 h and 24 h postincision. Platelet count, hemoglobin, platelet aggregometry (PA) with adenosine diphosphate (ADP) and collagen, and bleeding time (BT) were measured at 30 min before skin incision and at 3 h and 24 h postincision. Blood coagulation status was analysed using thromboelastography (TEG) at 30 min before skin incision and at 3 h postincision. Results: BT in the SK group at postincision increased significantly compared to preoperative value and were significantly higher than those of the GK and C group. PA with collagen at 3 h after skin incision was lower in the SK group than in the C group. There were no significant differences in any of the TEG variables among the three groups. No significant differences were observed in blood loss among the three groups. Conclusions: Blood loss was not increased by ketorolac under either general or spinal anesthesia, although platelet function was impaired under spinal anesthesia.
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Choi et al. (2005) conducted an RCT in Surgery requiring general or spinal anesthesia (n=45). Ketorolac vs. Saline was evaluated on Blood loss and platelet function (bleeding time, platelet aggregometry, TEG). Perioperative continuous infusion of ketorolac did not increase blood loss under either general or spinal anesthesia, although it impaired platelet function under spinal anesthesia.
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