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Ketorolac Use Shortens Hospital Length of Stay After Bariatric Surgery: a Single-Center 5-Year Experience

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Abstract

Introduction

There has been a recent increased interest in the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ketorolac for post-operative pain management to minimize opioid use and decrease hospital length of stay (LOS). Although NSAID use has been controversial following bariatric surgery due to anecdotal concerns for increased gastric bleeding, the impact of ketorolac as an adjunct to opioids needs further investigation on LOS and post-operative complications like bleeding.

Objective

This study aims to evaluate the impact of post-operative ketorolac use on opioid consumption, LOS, and bleeding risk after bariatric surgery.

Methods

We retrospectively analyzed a prospectively maintained database of all bariatric surgery patients who either underwent sleeve gastrectomy (SG) or Roux-en-Y gastric bypass surgery (RYGB) at a tertiary center between 2011 and 2015. Patients were stratified into 2 groups based on post-operative pain control regimen as follows: (1) ketorolac and opioids and (2) opioids alone.

Results

A total of 1555 patients were identified who underwent either SG (n = 1255) or RYGB (n = 300). The overall LOS was 1.81 ± .059 days for ketorolac-opioid patients vs. 2.09 ± .065 days for opioid-only patients (P < 0.001). Furthermore, the risk of post-operative bleeding was similar between the two groups (P = 0.097).

Conclusion

Patients who received ketorolac as an adjunct to opioids had a significantly shorter LOS compared to opioid-only patients. Additionally, ketorolac use was not associated with increased risk of post-operative bleeding complications. Therefore, if not contraindicated, ketorolac should be considered routinely for post-operative pain control among bariatric surgery patients.

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Authors and Affiliations

  1. The Garlock Division of General Surgery, Icahn School of Medicine at Mount Sinai Hospital, 5 East 98th Street, 3rd Floor, New York, NY, 10029, USA

    Kamyar Hariri, Elizabeth Hechenbleikner, Matthew Dong, Subhash U. Kini, Gustavo Fernandez-Ranvier & Daniel M. Herron

Authors
  1. Kamyar Hariri
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  2. Elizabeth Hechenbleikner
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  3. Matthew Dong
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  4. Subhash U. Kini
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  5. Gustavo Fernandez-Ranvier
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  6. Daniel M. Herron
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Corresponding author

Correspondence to Daniel M. Herron.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Hariri, K., Hechenbleikner, E., Dong, M. et al. Ketorolac Use Shortens Hospital Length of Stay After Bariatric Surgery: a Single-Center 5-Year Experience. OBES SURG 29, 2360–2366 (2019). https://doi.org/10.1007/s11695-018-03636-z

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  • DOI: https://doi.org/10.1007/s11695-018-03636-z

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