In pediatrics who underwent intracapsular tonsillectomy, a single dose of postsurgery ketorolac does not seem to be linked with a raised risk of post-tonsillectomy bleed, as per the findings of a study published in The International Journal of Pediatric Otorhinolaryngology. 

Caroline M Kolb et al. undertook a retrospective cohort study for retrospectively quantifying the post-tonsillectomy bleed rate following single-dose administration of ketorolac, an nonsteroidal anti-inflammatory drug (NSAID) for tonsillectomy. The investigators also examined whether the post-tonsillectomy bleeding risk is elevated by body mass index, age, medical comorbidities, indication for surgery, and gender.

The study recruited 1920 children (average age 6.5 years; 51.5% males; 63.9% were white) and segregated them into 2 groups: (i) Group  receiving ketorolac (75.9%, n=1458), and (ii) Group not receiving ketorolac (24.1%, n=462). The post-tonsillectomy hemorrhage needing operative intervention was the major endpoint of the study.

The postsurgery bleeding rate was reported to be 1.5%. But, during the comparison of ketorolac and non-ketorolac groups, no profound differences were noted in terms of post-tonsillectomy bleeding rate, as illustrated in Table 1:

For post-tonsillectomy hemorrhage, the pivotal risk factors were  higher body mass index Z-scores, age, behavioral diagnoses, chronic tonsillitis, and attention-deficit/hyperactivity disorder. Thus, ketorolac can minimize postoperative pain without magnifying post-tonsillectomy bleeding risk.