Ketorolac Use After Head and Neck Free Tissue Transfer Is Not Associated With Increased Flap Complications.

Byorth, Joseph K; Soule, Silvia M; Seliger, Brayden J; Bavier, Richard D; Drejet, Sarah M; Cannon, Richard B; Monroe, Marcus M; Buchmann, Luke O et al. · Head Neck · 2026

retrospective_cohort · Level III

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Abstract

The primary goal of the study is to assess bleeding complications and evaluate ketorolac for its safety in cancer patients undergoing head and neck free-flap surgery. Two cohorts of head and neck cancer patients undergoing free-flap surgery were identified using ICD-10 and CPT codes. Cohort 1 received ketorolac within 5 days of surgery (n = 2280); Cohort 2 did not receive ketorolac within 5 days of surgery (n = 2280). Postoperative hemorrhage occurrence and secondary outcomes were assessed. Ketorolac was not associated with increased risk of postoperative hemorrhage (RR: 0.825, p = 0.016), flap revisions (RR: 0.767, p < 0.001), blood vessel repair (RR: 0.528, p < 0.001), AKI (RR: 0.664, p = 0.003), and G-tube placement (RR: 0.884, p = 0.021). In this retrospective cohort, postoperative ketorolac was not associated with increased complications within the 30-day period.