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Krin135 at aol.com Krin135 at aol.com
Sat Apr 1 18:50:22 BST 2006

In a message dated 01-Apr-06 11:24:37 Central Standard Time,  
nick at macartney.org writes:

While I  accept this discussion is not about anaesthesia, I might point out
that in  the UK the datasheet says Ketorolac is contraindicated for
perioperative  care. A great shame, as I used it from its release.
Nick Macartney 

here's what MedScape has on its website:
Ketorolac tromethamine should be used very cautiously and with careful  
monitoring in patients who may be adversely affected by prolongation of bleeding  
time (e.g., patients receiving anticoagulant therapy, patients with hemophilia, 
 von Willebrand’s disease, or platelet deficiency) and only when the  
potential benefits justify the possible risks to the patient, since the drug may  
inhibit platelet function and hemorrhage is possible. (See Drug Interactions:  
Anticoagulants and Thrombolytic Agents.) In patients who receive anticoagulants  
for any reason, there is an increased risk of intramuscular hematoma 
formation  from administration of IM ketorolac tromethamine. In addition, since 
hematomas  and other signs of wound bleeding have been reported in patients 
receiving  ketorolac tromethamine perioperatively, the manufacturer states that  
postoperative administration of ketorolac tromethamine should be undertaken with  
caution in any patient in whom hemostasis is critical. 
or <http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2006-April/_http://tinyurl.com/pnpvc_ (http://tinyurl.com/pnpvc) >
All of the cases I sent over using the Ketorolac were other  wise healthy 
young persons without other bleeding complications. Since they  needed pain 
relief prior to transport, and the receiving surgeon (two hours  away) was 
unwilling to allow for opiates, I did not feel that I had much  choice.
Charles S. Krin, DO  FAAFP

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