Toradol (Ketorolac) To Reduce Ureteroscopy Symptoms Trial

You have accessJournal of UrologyStone Disease: Surgical Therapy III (PD26)1 Sep 2021PD26-02 TORADOL (KETOROLAC) TO REDUCE URETEROSCOPY SYMPTOMS TRIAL Jamil Syed, Amir Khan, Matthew Goland-Van Ryn, and Piruz Motamedinia Jamil SyedJamil Syed More articles by this author , Amir KhanAmir Khan More articles by this author , Matthew Goland-Van RynMatthew Goland-Van Ryn More articles by this author , and Piruz MotamediniaPiruz Motamedinia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002019.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To assess the use of intraoperative IV ketorolac on the peri-operative total milligram morphine equivalent (MME) requirements of patients undergoing ureteroscopy for nephrolithiasis. METHODS: Patients undergoing ambulatory ureteroscopy for nephrolithiasis were prospectively randomized to receive ketorolac at the time of anesthesia induction. Patients and surgeons were blinded to treatment. Exclusion criteria included NSAID related asthma or allergy, renal insufficiency, peptic ulcer disease, bleeding diathesis, pregnancy/breast feeding, advanced age, and inability to provide consent. Intraoperative, postoperative and combined MME were calculated. Multivariable regression was used to identify independent predictors of MME requirement. Complications were recorded. RESULTS: A total of 94 patients were randomized. There were 46 patients in the treatment arm and 48 patients in the control arm. There were no statistically significant differences in gender, age, BMI, operative length or baseline pain medication use between groups (p>0.05). Patients in the treatment arm required lower intraoperative MME when compared to the control arm (17.1 vs 24, p<0.01). There were no statistically significant differences in the postoperative MME requirements between groups. The combined peri-operative MME was lower in the treatment arm compared to the control arm (22.2 vs 30.4, p<0.02). Ketorolac use was an independent predictor of lower MME use on multivariable analysis (beta coefficient -5.1, p<0.01). There was no statistically significant difference with regards to complications between groups. CONCLUSIONS: Ketorolac at the time of ureteroscopy is associated with a 37% reduction in total narcotic requirement and is an independent predictor of decreased peri-operative narcotic needs. Ketorolac was not associated with an increase in complications. These findings show that intra-operative use of ketorolac effectively reduces narcotic requirements and should be considered independently or as part of a multimodal pain control protocol, unless otherwise contraindicated. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e437-e438 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jamil Syed More articles by this author Amir Khan More articles by this author Matthew Goland-Van Ryn More articles by this author Piruz Motamedinia More articles by this author Expand All Advertisement PDF downloadLoading ...