Perioperative Ketorolac Use and Postoperative Hematoma Formation in Reduction: A Single Surgeon Experience of 500 Consecutive Cases

Background: In light of the escalating opioid crisis, surgeons are increasingly focused on minimizing opioid use. Ketorolac has well-documented opioid-sparing effects in the postoperative period; however, its use is limited due to concerns of postoperative bleeding and hematoma formation. This study explores the relationship between hematoma formation and administration of perioperative ketorolac in adolescent females and young adult women undergoing reduction mammaplasty. It also aims to determine the effect of perioperative ketorolac administration on the requirement for opioid analgesia. Methods: We reviewed the medical records of 500 consecutive female patients who underwent reduction mammaplasty for bilateral macromastia from 2007-2017. We collected data pertaining to perioperative analgesia use and postoperative hematoma formation. Results: Five-hundred patients were included in analyses. The average age was 18.1 ± 2.2 years. Three hundred and eighty-nine (77.8%) patients received intravenous ketorolac during the perioperative period. Seven (1.4%) patients developed a postoperative hematoma. Hematoma was not associated with intraoperative ketorolac use, postoperative ketorolac use, or any perioperative ketorolac use (p>0.43, all). Intraoperative ketorolac use was associated with lower total intraoperative dosing of fentanyl and morphine and lower total postoperative dosing of oxycodone and morphine (p

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