IV Ketorolac on Platelet Function Post-Cesarean Delivery

• Status: Recruiting
• Trial end date: 2022-01-01
• Target enrollment: 0
• Participant gender: Female

Summary

Cesarean delivery has become the most common surgical procedure in the US. Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to improve the quality of post-cesarean analgesia and markedly reduce opioid consumption. The effect of NSAIDs on healthy volunteers results in inhibition of platelet aggregation and prolonged bleeding time. However, in the obstetric population, the presence and degree of platelet inhibition after NSAID exposure is less clear. The investigators plan to use Platelet Aggregometry and Thromboelastography (TEG) to evaluate the effect of ketorolac on platelets.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Beth Israel Deaconess Medical Center
• Collaborator: Society for Obstetric Anesthesia and Perinatology
• Treatments: Ketorolac; Ketorolac Tromethamine

Criteria

Inclusion Criteria:

• Pregnant

• Undergoing routine, scheduled cesarean section

• Gestation >37 weeks

• Singleton gestation

• Intraoperative anesthesia - 1.5 ml of intrathecal bupivicaine 0.75%, 25mcg of intrathecal fentanyl and 250 mcg of intrathecal morphine via Spinal or Combined Spinal Epidural

Exclusion Criteria:

• Pre-eclampsia with severe features or HELLP

• Allergy to NSAIDs

• Pre-existing bleeding disorder

• Other major risk factor for postpartum hemorrhage (placenta accreta, large uterine fibroid)

• Chronic kidney disease

• Plt count less than 100k

• Gastric ulcer or gastric bleeding

• Pre-existing uterine bleeding or disseminated intravascular coagulation

• Patient or Obstetrician refusal

• Intraoperative exclusion criteria - Postpartum hemorrhage (EBL >1000 ml) or unplanned intraoperative extension of surgery