Clinical Experience with Ketorolac in Children

OBJECTIVE:

To describe the use of parenteral ketorolac in a large population of children, focusing on dosing patterns, efficacy, and safety.

DESIGN:

Observational, prospective study conducted over a four-month period.

SETTING:

A 122-bed children's medical center located within an academic medical center hospital.

PARTICIPANTS:

Children receiving ketorolac during their hospitalization.

MAIN OUTCOME PARAMETERS:

Indications for treatment, dose, dosing interval, use of a loading dose, length of therapy, efficacy (subjective response and use of concomitant therapy), and adverse effects (bleeding, gastrointestinal ulceration or vomiting, and renal dysfunction).

RESULTS:

Of 112 children evaluated, 110 received ketorolac for analgesia, and 2 were given ketorolac as an antipyretic. The children ranged in age from 6 months to 19 years. Doses of 0.5 mg/kg q6h were used for most children (range 0.17–1.0). The average length of therapy was 3.4 days (range 1–12). The most frequent reason for discontinuing ketorolac therapy was a change to oral therapy. Therapy was discontinued because of a lack of efficacy in only 2 children. Adverse reactions were unusual, with only 2 patients having bleeding potentially associated with ketorolac use.

CONCLUSIONS:

Ketorolac appears to be a safe and effective therapy for children when given in appropriate doses for a limited duration.