Clinical Experience with Ketorolac in Children

Abstract

To describe the use of parenteral ketorolac in a large population of children, focusing on dosing patterns, efficacy, and safety. Observational, prospective study conducted over a four-month period. A 122-bed children's medical center located within an academic medical center hospital. Children receiving ketorolac during their hospitalization. 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). 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. Ketorolac appears to be a safe and effective therapy for children when given in appropriate doses for a limited duration.