The adverse effects of intravenous ketorolac related to postoperative hemorrhage and hematoma in adults aged 18 years and older: a systematic review protocol

Abstract

Review question/objective The objective of this review is to identify if intravenous ketorolac increases the incidence of postoperative hemorrhage and hematoma formation. The specific review question to be addressed is: Does intravenous ketorolac 15-30 mg given in the perioperative period to surgical patients 18 and older undergoing general anesthesia cause an increased incidence of postoperative hemorrhage and hematoma formation in the first 24 hours following surgery? Inclusion criteria Types of participants This review will consider studies that include adults aged 18 years and older that received general anesthesia and underwent surgery. The pediatric population will be excluded in order to conduct a systematic review that is specific to a certain patient population. Also, ketorolac doses for the pediatric population are weight-based, so they would have different dose ranges than adults. The type of surgery will be generalized and the search will include all surgical patients from all geographical regions and races. The postoperative period will be defined as the first twenty-four hours after surgery for this review. The perioperative period will be defined as the time from admission for surgery through the recovery room stay. Types of intervention(s)/phenomena of interest The intervention will be the intravenous administration of ketorolac at a dose between 15-30 mg in the perioperative period. The perioperative period will include ketorolac administration immediately before surgery, in the operative period, or in the immediate postoperative period. The comparison will be between the administration of ketorolac and the omission of ketorolac administration. Types of outcomes This review will consider studies that include the following outcome measures: •Incidence of hemorrhage within the first 24 hours postoperatively •Incidence of hematoma within the first 24 hours postoperatively.