Evidence map›Paper›PMID 40970949›Full record

SynthesisAesthetic plastic surgery2026

Perioperative Ketorolac and Hematoma Following Breast Reduction: A Systematic Review and Meta-analysis.

Victor F A Almeida, Glaudir Donato, Manoela Dantas, Eliana F R Duraes

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Victor F A AlmeidaDepartment of Anesthesiology, Cleveland Clinic Foundation, Cleveland, Ohio, 44195, USA.ORCID 0000-0001-8513-2827
Glaudir DonatoCenter of Medical Sciences, Federal University of Paraíba, João Pessoa, Brazil.ORCID 0000-0001-8081-9734
Manoela DantasCenter for Medical Sciences, University Center of João Pessoa - UNIPÊ, João Pessoa, Brazil.ORCID 0009-0009-8022-7902
Eliana F R DuraesDepartment of Plastic Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, Ohio, 44195, USA. ferreie@ccf.org.ORCID 0000-0002-3369-127X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKetorolac, a nonsteroidal anti-inflammatory drug, is a promising opioid-sparing option for postoperative pain control. However, its impact on platelet function raises concerns about bleeding risk. Reduction mammaplasty carries a known risk of hematoma, and this study aimed to assess whether perioperative ketorolac increases this risk.

methodsWe searched Cochrane Central, Embase, PubMed, and Web of Science databases for studies involving breast reduction patients who did or did not receive perioperative ketorolac. The primary outcome was hematoma formation, with secondary outcomes distinguishing between cases requiring surgery and those managed conservatively. A random-effects model calculated pooled odds ratios (OR) with 95% confidence intervals (CI), and heterogeneity was assessed using the I

resultsSeven studies involving 3,418 patients were included-1991 in the ketorolac group and 1427 in the control group. The hematoma incidence was 6.13% in the ketorolac group versus 6.73% in controls. Meta-analysis revealed a significantly increased risk of hematoma in ketorolac users (OR 2.63, 95% CI 1.58-4.37, p < 0.001, I

conclusionPerioperative ketorolac is associated with an increased risk of hematoma following breast reduction surgery. While it provides effective opioid-sparing analgesia, its use should be carefully considered, especially in patients with higher bleeding risks. Further randomized trials are needed to refine safety recommendations. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Indexed as

Anti-Inflammatory Agents, Non-SteroidalHematomaKetorolacMammaplastyPostoperative PainFemaleHumansPerioperative CareRisk AssessmentAnti-Inflammatory Agents, Non-SteroidalKetorolacAnalgesiaBreast reductionHematomaKetorolacNSAIDsPostoperative bleedingReduction mammaplasty

Identifiers

PMID40970949
PMCPMC12992376

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.