اثر بي دردي تزريق پري تونسيلار كتامين در مرحله قبل از عمل بر كاهش درد پس از عمل جراحي تونسيلكتومي اطفال: يك مطالعه از نوع دو سويه كور با كنترل دارونما

The pre-emptive analgesic effect of peritonsillar infiltration of ketamine for post operative pain relief in children following tonsillectomy. A randomized, double-blind, placebo-controlled study

Background and Aim: In multistudies, the use of ketamine for the preemptive analgesia in the management of postoperative pain is controversial. The purpose of our study was the clinical assessment of the efficacy of preincisional peritonsillar infiltration of two doses of ketamine on postoperative pain relief compared with preincisional peritonsillar infiltration of saline in children undergoing tonsillectomy. Materials and methods: Seventy-five ASA physical status I and II patients, aged 3 to 12 years, scheduled for tonsillectomy were enrolled in this randomized, double-blind, placebo-controlled study. Patients were divided into three groups of 25 each and received a local peritonsillar infiltration of 0.9% saline (Group A), ketamine 0.5 mg/kg (Group B), or ketamine 1 mg/kg (Group C). All medications were 2 ml in volume which was applied 1 ml per tonsil 3 min prior to tonsillectomy. The Childrenʹs Hospital Eastern Ontario Pain Scale (CHEOPS) and Wilson sedation scale were used to evaluate pain levels and sedative condition, respectively. Results: Group A had significantly higher CHEOPS scores than group B and group C. Group B and group C had comparable scores, which were not statistically significant (p> 0.05). During 24 hours after surgery, sixteen patients in group A and no patients in groups B or C needed analgesics (p < 0.001). Conclusion: A 0.5 or 1 mg/kg dose of ketamine given at approximately 3 min before surgery by peritonsillar infiltration provides efficient pain relief without side-effects in children undergoing tonsillectomy.