Dual NSAID Analgesia After Robotic Renal Surgery Shows No AKI Signal

This propensity-matched cohort suggests adding intravenous acetaminophen/ibuprofen to ketorolac patient-controlled analgesia does not raise short-term acute kidney injury risk after robot-assisted renal surgery in patients with normal baseline renal function.

acetaminophenibuprofenketorolacNSAIDspatient-controlled analgesiaacute kidney injuryrobot-assisted renal surgerynephrectomymultimodal analgesiapropensity score matchingretrospective cohort Nephrology / Renal Pharmacy

Background Information

Adding acetaminophen/ibuprofen to ketorolac PCA is safe for kidneys post-renal surgery.

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ketorolac in renal surgery can potentially increase the risk of acute kidney injury (AKI). The study found no significant increase in AKI risk when an intravenous combination of acetaminophen and ibuprofen was added to ketorolac-based patient-controlled analgesia (PCA). Adding acetaminophen and ibuprofen to ketorolac PCA in robot-assisted renal surgery does not appear to increase AKI risk, offering a potentially safe analgesic strategy. Limitations include the retrospective design and specific patient population. Additional acetaminophen and ibuprofen to ketorolac PCA does not increase postoperative AKI risk in robot-assisted renal surgery.

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Authors: Song SH, Lee S, Ryu JH, Oh AY, Jeon YT, Hong SK, Koo CH

Citation: Song SH, Lee S, Ryu JH, et al. Safety of additional intravenous acetaminophen/ibuprofen administration in patients undergoing robot-assisted renal surgery with postoperative ketorolac-based patient-controlled analgesia: A retrospective propensity-score-matched analysis. Investigative and clinical urology. 2026;67(4):366-374. doi:10.4111/icu.20260023

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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