Perioperative ketorolac increases post-tonsillectomy hemorrhage in adults but not children

Objectives/Hypothesis To evaluate the risk of post-tonsillectomy hemorrhage associated with perioperative ketorolac use. Study Design Systematic review and meta-analysis of primary articles reporting individual-level post-tonsillectomy hemorrhage rates in subjects receiving perioperative ketorolac and matched controls. Retrospective and prospective studies were both included. Methods PubMed search was performed for “[ketorolac OR toradol] AND tonsillectomy.” Articles fulfilling inclusion criteria were subjected to meta-analysis to determine summary relative risk (RR). Results Adults are at five times increased risk for post-tonsillectomy hemorrhage with ketorolac use (RR: 5.64; 95% confidence interval [CI]: 2.08–15.27; P