Use of intravenous ketorolac in the neonate and premature babies

Abstract

Ketorolac could represent an efficacious analgesic alternative to opioids, particularly in neonates. It would avoid the side-effects associated with opioid analgesics, especially respiratory depression.

Safety of ketorolac in surgical neonates and infants 0 to 3 months old

“…The Food and Drug Administration has approved ketorolac for use in children older than 2 years, and data describing its safe use in infants older than 6 months have also been described [1,4,7]. Papacci et al [8] previously reported 18 neonates to whom ketorolac was administered in a postoperative or postprocedural setting. They concluded ketorolac to be safe and efficacious in this age group.…”

Postoperative Ketorolac Tromethamine Use in Infants Aged 6–18 Months: The Effect on Morphine Usage, Safety Assessment, and Stereo-Specific Pharmacokinetics

“…Most children required remedication for pain within 4 h; 58% for ketorolac and 63% for morphine. Papacci et al (19) reported significant analgesic efficacy within 0.5 h and up to 6 h after dose in an observational unblinded study of 18 neonates and premature babies given 1 mg/kg IV ketorolac for postoperative or procedure-related pain.…”

Safety of ketorolac in neonates and infants after cardiac surgery

“…The primary strategy for treatment of pain in postoperative cardiac patients is the administration of opioids. However, after cardiac surgery, infants may be physiologically and anatomically predisposed to respiratory depression with administration of opioids (6). Therefore, maintaining analgesia while minimizing adverse effects in very young postoperative patients is a challenge.…”