Welcome to our archive of questions asked during the last few years of our online discussion featured in SAMBA Talks, our monthly eNewsletter. If you would like to propose a new question for discussion or if you would like to enter an additional comment for a particular question, send us a note. If you are submitting an additional comment, please tell us the question to which the comment belongs.

Please note: The information presented in the replies below does not represent SAMBA policy. The replies are solely the opinions of the individuals who wrote them.

Postoperative Issues/Should Toradol be used for children after dental surgery?

QUESTION:

Does anyone advocate the use of Toradol in children for dental rehab? It seems to me that children are calmer on wake-up when it is used. They don't seem as wild on wake-up and don't require that extra dose of narcotic to settle them down.

-- From Debra Tyler, M.D., Dallas, TX

REPLY:

Obviously, better pain control is good for everyone. However, there are a couple of studies showing that children have a smoother emergence when given a narcotic. I don't know if this is because of something good about narcotics (such as decreased cough reflex or just being stoned), or just better pain control. If the kids are old enough, why not use a COX-2 agent orally rather than one that might inhibit platelet function? I'd also check with the dentists to see if they have any thoughts on the platelet issue.

-- From Alan P. Marco, M.D., M.M.M., Toledo, OH

REPLY:

Unless there are specific contraindications to the administration of ketorolac, our group tries to make it a habit of administering 0.5 mg/kg of ketorolac as adjunct analgesic for pediatric dental cases. We perform 10-15 of those cases per week and have found ketorolac to be quite helpful. The oral surgery literature has a great wealth of information about NSAIDs and dental procedures. However, we do not use ketorolac in children less than 18 - 24 months of age due to its unknown affects upon the kidney.

-- From Andrew Herlich, D.M.D., M.D., Philadelphia, PA

© SOCIETY FOR AMBULATORY ANESTHESIA
520 N. Northwest Highway Park Ridge, Illinois 60068-2573
Tel: (847) 825-5586 Fax: (847) 825-5658
E-mail: samba@asahq.org