The role of ketorolac in decreasing length of stay in patients with gynecologic malignancies

Objective: To determine whether postoperative ketorolac use is associated with decreased length of stay in patients with gynecologic malignancies. Methods: A retrospective review of 150 patients undergoing hysterectomy for cervical or uterine cancer between 1996 and 1998 was conducted. Information was collected on length of stay and postoperative course. Ketorolac users and non-users were compared using the two-sample t-test and Fisher’s exact test. Regression analysis was performed to control for year of surgery, age, stage of disease, and operative procedure. Results: Patients who received ketorolac (n = 87) compared to those who did not (n = 63) had shorter length of stay (4.0 vs. 5.4 days P < 0.001). The difference remained statistically significant after regression analysis was performed to control for confounding variables. The ketorolac group used less morphine (76.2 mg vs. 105.8 mg, P = 0.003), tolerated feeding earlier (P < 0.001), and experienced less ileus (6.9%vs. 19%, P = 0.039) and fever (5.7%vs. 19%, P = 0.017). Mean pain scores, postoperative infection rates, and readmission rates were not different between the two groups. Conclusion: In patients undergoing surgery for gynecologic malignancies, the use of ketorolac for postoperative pain control was associated with decreased length of stay. Less morphine use and decreased incidence of postoperative complications may have resulted in earlier discharge.