Ketorolac Administration Reduces Opioid Usage in Postoperative Pituitary Adenoma Patients

Introduction: The use of opioid pain medications postoperatively presents the risk of inadvertent dependence. Overprescription of opioids contributed to the recent “epidemic” of opioid abuse, and since then, much effort has been placed into effectively reducing narcotic consumption for pain management. Coadministration of NSAIDs alongside opioids has been explored relatively recently as an alternative pain management regimen, and has gained prominence in the neurosurgical field in the context of transsphenoidal surgeries. Our pilot research aims to determine the association between ketorolac coadministration and post-operative opioid usage in pituitary adenoma patients.

Methods: Following IRB approval, a retrospective chart review was conducted on pituitary adenoma patients (n = 216), and the postoperative pain management regimen (ketorolac + opioids or opioids only) was noted. Opioid consumption was noted in MME (morphine milligram equivalents). Student t-tests were conducted to determine statistical significance.

Results: For patients only receiving opioids (n = 209), the average opioid consumption was 120.4 MME, while for patients receiving both opioids and ketorolac (n = 7), the consumption was 73.2 MME. This represented a difference of 39.2% (p = 0.098). No complications related to ketorolac were identified.

Conclusion: Our pilot research demonstrates that the addition of ketorolac in postoperative pain management for pituitary adenoma patients may help reduce opioid usage. Further study is needed in this area for statistical power. Our work does show a safe addition to postoperative pain management, and the implications may impact patient recovery, satisfaction, and opioid complications and dependence.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
12 February 2021