{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:11:11Z","timestamp":1788667871561,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"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 Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the safety of immediate postoperative single-dose ketorolac after primary palatoplasty (PP) and assess its efficacy in reducing opioid use and improving other recovery metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort with historical controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary pediatric hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients, Participants<\/jats:title>\n                    <jats:p>Two hundred forty-nine patients who underwent PP between 2009 and 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Following institutional implementation of routine ketorolac use after PP, 124 patients who received an immediate postoperative single dose of IV ketorolac (median 0.5\u2005mg\/kg) were compared with 125 patients who did not receive ketorolac.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Safety outcomes included significant bleeding, supplemental oxygen requirements, and 30-day postoperative complications. Efficacy outcomes were assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) scale, postoperative opioid use, time to first oral intake, and antiemetic use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant differences were observed between groups regarding the minimal rates of postoperative bleeding, need for supplemental oxygen, or other adverse events. Postoperative FLACC scale was significantly lower in the ketorolac group during the first postoperative hour (adjusted difference: 0.54, 95% CI: 0.04-1.03,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.033) and hours 1 to 3 (adjusted difference: 0.44, 95% CI: 0.02-0.85,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.039). The ketorolac group also had lower total opioid use during hospitalization, earlier initiation of oral intake, and shorter length of stay, though these differences were not significant after multivariable adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immediate postoperative single-dose ketorolac after PP is associated with improved early postoperative pain control without increasing complication rates. Other observed potential benefits deserve further attention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251408204","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T17:16:32Z","timestamp":1766078192000},"page":"3291-3298","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reevaluating Single-Dose Ketorolac for Primary Palatoplasty Postoperative Pain Management"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6229-1698","authenticated-orcid":false,"given":"Athena","family":"Zhang","sequence":"first","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4422-9635","authenticated-orcid":false,"given":"Sofia A.","family":"Finestone","sequence":"additional","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Chestang","sequence":"additional","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Sohel","family":"Rana","sequence":"additional","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2049-8902","authenticated-orcid":false,"given":"Arnav","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0552-4626","authenticated-orcid":false,"given":"Liara S.","family":"Ortiz-Ocasio","sequence":"additional","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2294-2878","authenticated-orcid":false,"given":"Theodore S.","family":"Hyman","sequence":"additional","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9821-1241","authenticated-orcid":false,"given":"Esperanza","family":"Mantilla-Rivas","sequence":"additional","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary F.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert K.","family":"Oh","sequence":"additional","affiliation":[{"name":"Children's National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/BDR2.2301"},{"key":"e_1_3_4_3_2","unstructured":"Parameters of care for evaluation and treatment of individuals with cleft lip\/palate and\/or other craniofacial conditions."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/PAN.13639"},{"key":"e_1_3_4_5_2","unstructured":"FDA Drug Safety Communication: FDA requires labeling changes for prescription opioid cough and cold medicines to limit their use to adults 18 years and older|FDA. 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