From the Guidelines
Toradol (Ketorolac) can be used in patients who have undergone Roux-en-Y gastric bypass surgery, with a recommended dose of 0.15-0.2 mg kg-1 (max 10 mg) every 6 hours, limited to a maximum of 48 hours of use, as per the guidance from the European Society for Paediatric Anaesthesiology 1. When considering the use of Toradol in patients post-Roux-en-Y procedure, it's essential to weigh the benefits of effective pain management against potential risks. The dose suggested by the European Society for Paediatric Anaesthesiology 1 is specifically for short-term therapy, which aligns with the need for careful management of postoperative pain in these patients.
- Key considerations include:
- Monitoring renal function, as Toradol can affect kidney function 1.
- Being aware of the potential for gastrointestinal bleeding, which may be heightened in post-surgical patients, although this specific risk is not detailed in the provided study 1.
- Ensuring adequate hydration to minimize the risk of renal impairment.
- Considering alternative pain management strategies for use beyond the recommended 48-hour duration to avoid prolonged exposure to NSAIDs. The use of Toradol in this context is beneficial due to its efficacy as a non-steroidal anti-inflammatory drug (NSAID) for pain relief without the opioid-related side effects of constipation or respiratory depression, which can be particularly problematic after gastric surgery. However, the decision to use Toradol must be made on a case-by-case basis, taking into account the individual patient's risk factors and medical history.
From the Research
Relationship Between Roux-en-Y Procedure and Toradol (Ketorolac)
- The use of ketorolac (Toradol) in patients who have undergone Roux-en-Y gastric bypass surgery has been studied in terms of its effectiveness for postoperative pain management and its potential impact on hospital length of stay and bleeding risk 2.
- Research has shown that ketorolac can be used safely and effectively for postoperative pain control in bariatric surgery patients, including those who have undergone Roux-en-Y gastric bypass, without increasing the risk of postoperative bleeding 2, 3.
- A study found that patients who received ketorolac as an adjunct to opioids after bariatric surgery had a significantly shorter hospital length of stay compared to those who received opioids alone 2.
- The use of ketorolac has been found to be beneficial in minimizing opioid use and decreasing hospital length of stay after bariatric surgery, including Roux-en-Y gastric bypass 2.
- There is no direct evidence to suggest that ketorolac (Toradol) has a specific interaction with the Roux-en-Y procedure that would affect its use or efficacy in these patients, beyond its general use in postoperative pain management 4, 2, 3.