The use of periarticular ketorolac, an anti-platelet agent, does not produce additional blood loss in patients undergoing total knee arthroplasty (TKA), a retrospective study presented here on Monday, June 22nd at the annual meeting of the Canadian Anesthesiologists’ Society concludes.
The study compared 57 patients who received periarticular ketorolac injection and 33 patients who didn’t (controls).
Because ketorolac is an anti-platelet and is commonly used, Jennifer Plester, MD, University of Manitoba, Winnipeg, Manitoba, and colleagues sought to examine the impact of the medication on blood loss.
The researchers found that total blood loss was 1.24 L among control patients compared with 1.41 L amongst patients who received ketorolac. A blood transfusion following surgery for 1 patient was required in each study arm.
Investigators observed decreased pain at rest on postoperative day 1 among patients who received ketorolac injections, but the difference was lost on day 2. The researchers also saw no differences in opioid consumption or length of stay in hospital between groups.
Future research may examine the impact of ketorolac on blood loss in TKA patients considered at elevated risk for blood loss, said Dr. Plester.
“We only looked at patients who were only at low risk for blood loss and excluded those at high risk,” she said. “Patients with renal disease, hepatic disease, or underlying anaemia have a propensity to bleed, and we didn’t look at patients who would have an increased risk of bleeding.”
The population of patients who undergo knee replacement surgery are often elderly, have co-morbidities and would likely be considered at elevated risk for bleeding, she added.