Methods/Technique: A PUBMed/Medline literature search using the following keywords: “Surgery” and “NSAID”, limited to clinical trials, yielded 2574 results. Of these, 1036 include Toradol. Upon further review, twelve involved a cohort of plastic surgery patients. Six reported postoperative hematoma rates: three prospective randomized trials, two retrospective reviews, and one case series. The data were then subjected to statistical analysis using Students t-test to determine if an association existed between Toradol use and postoperative hematomas. The level of significance is defined as p<0.05.
Results/Complications: From six papers, data from 951 reported cases were extracted. Overall, Toradol use resulted in similar hematoma rates when compared to control groups, 2.5% (12 of 483) versus 2.6% (12 of 468) respectively (p = 0.81). There were no reported hematomas associated with Toradol in over 121 patients undergoing aesthetic facial procedures. Hematoma rates of those undergoing aesthetic breast surgery, including reduction and augmentation mammoplasties, were 2.3% (6 of 257) in the Toradol group versus 4.0% (11 of 277) in controls. All relevant studies showed a reduction in postoperative narcotic use and improved pain scores.
Conclusion: Our literature review did not find a significant association with hematoma formation and Toradol use in plastic surgery patients. These findings are similar to meta-analysis performed in other surgical subspecialties. Although we do not recommend Toradol use in all situations, we have found that Toradol can be used safely in select plastic surgery patients as an adjunct for postoperative pain.