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Stone SB. Ketorolac in Postoperative Neonates and Infants: A Systematic Review. J Pediatr Pharmacol Ther. 2021;26(3):240-247doi: 10.5863/1551-6776-26.3.240.
Stone, S. B. (2021). Ketorolac in Postoperative Neonates and Infants: A Systematic Review. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 26(3), 240-247. https://doi.org/10.5863/1551-6776-26.3.240
Stone, Sadie B. "Ketorolac in Postoperative Neonates and Infants: A Systematic Review." The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG vol. 26,3 (2021): 240-247. doi: https://doi.org/10.5863/1551-6776-26.3.240
Stone SB. Ketorolac in Postoperative Neonates and Infants: A Systematic Review. J Pediatr Pharmacol Ther. 2021;26(3):240-247. doi: 10.5863/1551-6776-26.3.240. Epub 2021 Mar 31. PMID: 33833624; PMCID: PMC8021237.
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J Pediatr Pharmacol Ther. 2021;26(3):240-247. doi: 10.5863/1551-6776-26.3.240. Epub 2021 Mar 31.

Ketorolac in Postoperative Neonates and Infants: A Systematic Review.

The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG

Sadie B Stone

PMID: 33833624 PMCID: PMC8021237 DOI: 10.5863/1551-6776-26.3.240

Abstract

OBJECTIVE: To evaluate the pharmacokinetics and pharmacodynamics, dosing, efficacy, and safety of ketorolac in postoperative patients younger than 6 months of age.

METHODS: PubMed (1988-July 2020), Medline (1946-July 2020), and EBSCO Discovery Service (1988-July 2020) were searched to identify relevant published articles using the following search terms: ketorolac, neonate, infant. English-language articles evaluating the use of ketorolac in infants younger than 6 months of age were included.

RESULTS: Eight reports that included 239 infants receiving ketorolac were included. Of the included patients, 237 were younger than 6 months of age. Ketorolac exhibits rapid elimination of the analgesia-producing S (-) isomer, elimination half-life of 0.83 hours. Most patients received 0.5 mg/kg/dose every 6 hours for 48 to 72 hours. Analgesia was demonstrated by reduced use of open-label morphine and significant lowering of Neonatal/Infant Pain Scale scores. Adverse effects were minimal when ketorolac was used in term neonates and infants without baseline renal dysfunction.

CONCLUSIONS: Randomized placebo-controlled trials of ketorolac use in this population are lacking; however, most published reports noted efficacy and safety with ketorolac in properly selected infants.

Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: [email protected] 2021.

Keywords: acute pain; analgesics, non-narcotic; infant; ketorolac; neonate

Conflict of interest statement

Disclosure. The author declares no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria.

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