Ketorolac suppresses postoperative bladder spasms after pediatric ureteral reimplantation

John M. Park, Constance S. Houck, Navil F. Sethna, Lorna J. Sullivan, Anthony Atala, Joseph G. Borer, Bartley G. Cilento, David A. Diamond, Craig A Peters, Alan B. Retik, Stuart B. Bauer

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


We evaluated the efficacy of ketorolac in suppressing postoperative bladder spasms after ureteroneocystostomy (ureteral reimplantation). Twenty- four pediatric patients undergoing intravesical ureteroneocystostomy were enrolled prospectively to receive either ketorolac or placebo via double- blinded randomization. Twelve patients in each group shared similar preoperative characteristics. All were maintained on an epidural infusion of bupivacaine (0.1%) with fentanyl (2 μg/mL) throughout the study. Patients were given either ketorolac (0.5 mg · kg-1 · dose-1) or placebo (equivalent volume saline) IV after surgery and every 6 h thereafter for 48 h. Parents were instructed to record bladder spasm episodes prospectively by using a standardized time-flow diary. Three patients (25%) in the ketorolac group experienced bladder spasms, compared with 10 patients (83%) in the placebo group (two-sided P < 0.05). The median severity score for the ketorolac group was 1.2 (mild = 1.0, severe = 3.0), compared with 2.6 for the placebo group (P = 0.003). We conclude that IV ketorolac reduces the frequency and severity of postoperative bladder spasms after intravesical ureteroneocystostomy.

Original languageEnglish (US)
Pages (from-to)11-15
Number of pages5
JournalAnesthesia and analgesia
Issue number1
StatePublished - Jul 2000

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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