Pain prevention with intraoperative ketamine in outpatient children undergoing tonsillectomy or tonsillectomy and adenotomy.
OBJECTIVE
To evaluate the effectiveness of ketamine in the prevention of postoperative pain after tonsillectomy.


METHODS
Randomized, prospective, double-blind study.


METHODS
University hospital.


METHODS
90 ASA physical status I and II patients, aged 5 to 15 years, scheduled for tonsillectomy or adenotonsillectomy.


METHODS
Patients were divided into three groups. The pain preventive group received intravenous (IV) ketamine 0.5 mg/kg in 2 mL saline before the tonsils were surgically removed, followed by a continuous IV infusion of ketamine at 6 micro/(kg/min). In the ketamine group, 2 mL saline was given before the tonsils were surgically removed; saline infusion (10 mL/h) was continued until bleeding control, and 0.8 mg/kg ketamine was given during bleeding control in 2 mL saline. In the control group, only saline was given.


RESULTS
Cardiorespiratory system data, recovery from anesthesia and discharge parameters, tramadol requirement, and complications were recorded. Recovery from anesthesia and discharge parameters were similar among the groups. Total dose of tramadol was lower in the pain preventive group than in the other groups. In the pain preventive group, verbal pain scale scores were lower in the early postoperative period in the fourth and sixth hours (P < 0.05).


CONCLUSIONS
Ketamine decreases postoperative analgesic requirements and has analgesic effects when used before surgery in tonsillectomy/adenotonsillectomy.
Aydin
Osman N
ON
Anesthesiology and Reanimation/Algology, Adnan Menderes University, Medical Faculty, Aydin, Turkey. onaydin@superonline.com
Ugur
Bakiye
B
Ozgun
Sanem
S
Eyigör
Hülya
H
Copcu
Ozgen
O
D000233:Adenoidectomy / Q000009:adverse effects*; D000293:Adolescent; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000762:Anesthesia Recovery Period; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous / Q000379:methods; D007430:Intraoperative Care / Q000379:methods*; D007649:Ketamine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D013997:Time Factors; D014068:Tonsillectomy / Q000009:adverse effects*; D014147:Tramadol / Q000008:administration & dosage; D016896:Treatment Outcome
D000700:Analgesics; D000701:Analgesics, Opioid; D014147:Tramadol; D012965:Sodium Chloride; D007649:Ketamine