Efficacy and Safety of Ketorolac for Pain Management After Congenital Heart Surgery: A Comparison to Paracetamol

Abstract

Background: Pain is an unpleasant complication commonly observed following congenital heart surgery, but is not often treated properly. Objectives: The current study aimed to investigate the efficacy and safety of ketorolac to manage postoperative pain after pediatric heart surgery. Methods: Eighty-one pediatric patients undergoing cardiac surgery received either ketorolac 0.5 mg/kg or paracetamol 15 mg/kg for postoperative pain control every six and eight hours on the first and second postoperative days, respectively. The critical-care pain observation tool (CPOT) and the face, legs, activity, cry, consolability (FLACC) scale were employed to investigate the pain severity. The patients were also investigated for additional analgesic requirements, and associated complications including acute kidney injury, gastrointestinal discomfort and bleeding in patients. Results: Patients in the ketorolac group experienced less pain than the ones in the paracetamol group. More fentanyl was required for pain relief in the paracetamol than the ketorolac group. Use of ketorolac was not associated with more adverse effects in comparison to paracetamol. Conclusions: Ketorolac is safe and effective to manage postoperative pain after congenital heart surgery. It is more effective than paracetamol for pain relief and requires less additional rescue analgesic.