{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:02:53Z","timestamp":1785308573581,"version":"3.55.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Ketorolac is commonly cautioned with a possible effect of bleeding. The safety and efficacy of Ketorolac has not been examined in children who have undergone general surgery procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single institution retrospective cohort study examining children ages 0-18 from 2017-2022 with and without Ketorolac &lt;24\u00a0hours after the following operations: laparoscopic appendectomy, laparoscopic cholecystectomy, laparoscopic or open inguinal hernia repair, umbilical hernia repair, and ventral hernia repair. Demographics were reported using bivariate inferential statistics. A Cox proportional hazards model identified associations between Ketorolac and time to pain score \u22643. Logistic regression measured odds of opioid use in morphine equivalents 24-hour after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      5455 patients were identified. Children who received Ketorolac after surgery were more likely to be older (11.5 vs 7.0 years,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). Compared to Whites, Asian Americans (OR .50, CI .36-.63,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001) and African Americans (OR .22, CI .13-.37,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001) were less likely to receive Ketorolac. Patients receiving Ketorolac were more likely to have a high pain score (&gt;5) after surgery (40% vs 23%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001) when receiving Ketorolac vs opioid alone (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). Patients receiving Ketorolac had 40% decreased odds of receiving opioid after surgery (OR .90, 95% CI: .87-.94,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). Blood transfusions were less common in patients that received Ketorolac (0.2% vs 0.7%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ketorolac does not increase the risk of bleeding requiring transfusion and decreases opioid administration. Ketorolac is efficacious in this patient population either alone or in combination with opioids and improves pain control compared to opioids alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261419764","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T13:02:50Z","timestamp":1773406970000},"page":"2413-2419","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Safety and Efficacy of Ketorolac in the Management of Pain for Postoperative Pediatric General Surgery Patients"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3460-4573","authenticated-orcid":false,"given":"Zoe","family":"Flyer","sequence":"first","affiliation":[{"name":"Division of Pediatric Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7633-3690","authenticated-orcid":false,"given":"Andreina","family":"Giron","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery"},{"name":"University of California, Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"John","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Schomberg","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Carlson","sequence":"additional","affiliation":[{"name":"University of California, Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Maria","family":"Dumitr","sequence":"additional","affiliation":[{"name":"University of California, San Diego"},{"name":"Children\u2019s Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don","family":"Wen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Rohloff","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Lusk","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Orange County"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter T.","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery"},{"name":"University of California, Irvine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.1996.tb05040.x"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1021\/jm201090k"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2021.11.019"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/9783527607495"},{"key":"e_1_3_3_6_2","unstructured":"Drugs.com. Ketorolac tromethamine monograph for professionals; 2024. Retrieved July 15 2025 from. https:\/\/www.drugs.com\/monograph\/ketorolac.html"},{"key":"e_1_3_3_7_2","unstructured":"University of Illinois Chicago Drug Information Group. What evidence is there for the 5-day maximum with the use of ketorolac? 2022; Retrieved July 15 2025 from. https:\/\/dig.pharmacy.uic.edu\/faqs\/2022-2\/september-2022-faqs\/what-evidence-is-there-for-the-5-day-maximum-with-the-use-of-ketorolac\/"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4637.2001.01043"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03530290046036"},{"key":"e_1_3_3_10_2","volume-title":"Ketorolac Tromethamine: Package Insert","author":"Hikma Pharmaceuticals","year":"2021","unstructured":"Hikma Pharmaceuticals. Ketorolac Tromethamine: Package Insert. U.S. Food and Drug Administration; 2021. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2021\/074590s043lbl.pdf"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000438459.60474.b5"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3171\/2015.4.PEDS14411"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002401"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2024.111953"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-012-9682-z"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2017.06.010"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2017.05.087"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012294.pub2"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24555"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/14740338.2019.1571037"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.3171\/2015.4.PEDS14411"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1080\/24740527.2020.1847600"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000002703"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.86789"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261419764","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261419764","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261419764","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:19:42Z","timestamp":1785305982000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261419764"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":23,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/00031348261419764"],"URL":"https:\/\/doi.org\/10.1177\/00031348261419764","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,13]]}}}