Abstract P-497: EFFECT OF KETOROLAC ON POST-OPERATIVE CARE OF INFANTS WITH VENTRICULAR SEPTAL DEFECTS AND ATRIOVENTRICULAR CANAL DEFECTS

Aims & Objectives: Intravenous Ketorolac is used for pediatric post-operative care due to its anti-inflammatory and analgesic properties, as well as the potential to decrease need for opioids. Minimal data exists regarding its use in infants under six months, yet our institution frequently uses Ketorolac post-cardiovascular surgery. We sought to investigate whether the use of ketorolac can have clinical benefit in comparison with opioids. Methods We conducted a retrospective chart review of patients under six months of age admitted post-operatively for ventricular septal defect (VSD) and/or atrioventricular canal (AVC) repair between January 2013-September 2017. Outcomes including opiate dose, length of stay (LOS), time to full enteral feeds, and ventilator days were compared between subjects exposed to ketorolac and an unexposed control group. Results Thirty-one children were included, of whom 55% (n=17) received at least one dose of Ketorolac (median total ketorolac dose 4 mg/kg (25–75% IQR 3–5 mg/kg)). Comparing patient characteristics and outcomes between the Ketorolac exposed and unexposed cohorts, there were no differences in age, gender, duration mechanical ventilation, time to full enteral nutrition, or ICU LOS. Most (94%) children received at least one dose of opioid. Opioid duration and total morphine equivalents (per kg) received was not decreased in the Ketorolac cohort (median 0.6 (25–75% IQR 0.4–1.7) vs 0.9 (25–75% IQR 0.4–4.0); p=0.55). Total opioid dose correlated with ICU LOS (r2=0.15; p=0.03), but total Ketorolac dose did not. Conclusions In this small cohort, Ketorolac use was not associated with a reduction in opioid exposure or differences in clinical outcomes.