{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:59:19Z","timestamp":1792205959883,"version":"4.4.0"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T00:00:00Z","timestamp":1731715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the safety and effectiveness of dose\u2010related ketorolac administration in children who underwent tonsillectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Data sourced from PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases, encompassing literature from their inception until June 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>The perioperative administration of ketorolac in comparison with a control group was included in this analysis. The outcomes assessed were postoperative pain levels; utilization patterns of analgesic medication in terms of quantity and frequency; and the incidence rates of postoperative nausea, vomiting, and bleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighteen studies with 11,729 patients that investigated. The ketorolac treatment group with postoperative bleeding had a higher incidence of primary bleeding (significant bleeding and operative bleeding control) compared to the control group. However, ketorolac treatment did not affect the risk of secondary bleeding. Subgroup analysis showed that 0.9 to 1\u2009mg\/kg of ketorolac significantly increases primary operative control (odds ratio [OR]\u2009=\u20094.0700 [1.6352; 10.1302];\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.0%) and primary significant bleeding (OR\u2009=\u20092.3200 [1.1322; 4.7538];\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.0%). On the other hand, 0.5\u2009mg\/kg ketorolac did not show any influence on primary operative control. The administration of ketorolac (both 0.9\u20101 and 0.5\u2009mg\/kg) led to a significant decrease in postoperative pain (2\u201024\u2009hours), nausea, and vomiting compared to the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low\u2010dose (0.5\u2009mg\/kg) ketorolac administration to children could significantly reduce the risk of primary significant bleeding and surgical hemostasis compared to high\u2010dose administration (0.9\u20101.0\u2009mg\/kg). In addition, low\u2010dose ketorolac administration could provide sufficient pain control and reduce postoperative nausea and vomiting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.1057","type":"journal-article","created":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T03:58:36Z","timestamp":1731729516000},"page":"821-832","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Dose\u2010Related Effects and Bleeding Risk of Ketorolac in Pediatric Tonsillectomy"],"prefix":"10.1002","volume":"172","author":[{"given":"Do Hyun","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery and Communication Sciences Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2838-7820","authenticated-orcid":false,"given":"Se Hwan","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea Bucheon\u2010si Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-023-02668-z"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202310-1857ST"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2174\/1574886311666160719154420"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2015.02.005"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2017.12.009"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.12.005"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816683915"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21242"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.05.018"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24555"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03011766"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3126\/kumj.v21i1.55983","article-title":"Post\u2010tonsillectomy hemorrhage in patients receiving ketorolac analgesic","volume":"21","author":"Yadav D","year":"2023","journal-title":"Kathmandu Univ Med J"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000438459.60474.b5"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4637.2001.01043.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/19458924241251387"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.18787\/jr.2024.00015"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.18787\/jr.2024.00006"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2024.111953"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(99)70271-8"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2256"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199512000-00004"},{"key":"e_1_2_8_24_1","first-page":"43","article-title":"Comparative study between the effect of diclofenac and ketorolac in post\u2010tonsillectomy pain management","volume":"6","author":"Roushdy MMM","year":"2020","journal-title":"Egypt J Neck Surg Otorhinolaryngol"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13662"},{"key":"e_1_2_8_26_1","unstructured":"HamzaAA HayatU KhanQ. 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