<p>The ACOG recommends a multimodal approach to postoperative pain that includes nonsteroidal NSAIDs, acetaminophen, and opioids. Ketorolac is a favored NSAID for postop pain control. However, the optimal dose of ketorolac after cesarean delivery has not been determined. In this episode, we will summarize a brand new randomized, controlled, single-blind trial of pregnant women undergoing cesarean delivery under regional anesthesia at a large academic medical center between June 2022 and October 2023. Enrolled participants were randomized to receive an initial loading dose of 60 mg (intervention) or 30 mg (control) of intravenous ketorolac in the operating room at the end of surgery.</p><p><br></p><p>1.	Pharmacologic Stepwise Multimodal Approach for Postpartum Pain Management: ACOG Clinical Consensus No. 1. Obstetrics and Gynecology. 2021.</p><p>2.	Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstetrics and Gynecology. 2020.</p><p>3.	Eid, Joe MD; Caplan, Madeleine MD; Goel, Nidhi MD; Poirier, Marie-Veronique MD; Montaine-O&#39;Brien, Skyler MS; Rood, Kara M. MD; Costantine, Maged M. MD. Two Perioperative Ketorolac Dosing Regimens After Cesarean Delivery and Opioid Use: A Randomized Controlled Trial. O&amp;G Open 3(2):e159, April 2026. | DOI: 10.1097/og9.0000000000000159</p><p><br></p>

Dr. Chapa’s OBGYN Clinical Pearls

Dr. Chapa’s Clinical Pearls

Best Dose of Ketorolac for C-Section Pain Prophylaxis?

APR 25, 202622 MIN
Dr. Chapa’s OBGYN Clinical Pearls

Best Dose of Ketorolac for C-Section Pain Prophylaxis?

APR 25, 202622 MIN

Description

<p>The ACOG recommends a multimodal approach to postoperative pain that includes nonsteroidal NSAIDs, acetaminophen, and opioids. Ketorolac is a favored NSAID for postop pain control. However, the optimal dose of ketorolac after cesarean delivery has not been determined. In this episode, we will summarize a brand new randomized, controlled, single-blind trial of pregnant women undergoing cesarean delivery under regional anesthesia at a large academic medical center between June 2022 and October 2023. Enrolled participants were randomized to receive an initial loading dose of 60 mg (intervention) or 30 mg (control) of intravenous ketorolac in the operating room at the end of surgery.</p><p><br></p><p>1. Pharmacologic Stepwise Multimodal Approach for Postpartum Pain Management: ACOG Clinical Consensus No. 1. Obstetrics and Gynecology. 2021.</p><p>2. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstetrics and Gynecology. 2020.</p><p>3. Eid, Joe MD; Caplan, Madeleine MD; Goel, Nidhi MD; Poirier, Marie-Veronique MD; Montaine-O&#39;Brien, Skyler MS; Rood, Kara M. MD; Costantine, Maged M. MD. Two Perioperative Ketorolac Dosing Regimens After Cesarean Delivery and Opioid Use: A Randomized Controlled Trial. O&amp;G Open 3(2):e159, April 2026. | DOI: 10.1097/og9.0000000000000159</p><p><br></p>