title: Assessing intravenous ketamine and intravenous dexamethasone separately and in combination for early oral intake, vomiting and postoperative pain relief in children following tonsillectomy.
abstract: BACKGROUND
  The aim of the present study is to evaluate the effect of preoperative 0.5 mg/kg i.v. dexamethasone in combination with 0.5 mg/kg i.v. ketamine on pain, early oral intake and vomiting in pediatric patients undergoing tonsillectomy during the first 24 hours of the postoperative period.
  
  
  METHODS
  One hundred twenty children who were scheduled for tonsillectomy were randomly assigned to receive a single dose of dexamethasone 0.5 mg/kg i.v. as Group D (n = 30), receive ketamine 0.5 mg/kg i.v. as Group K (n = 30), receive dexamethasone 0.5 mg/kg i.v. and ketamine 0.5 mg/kg i.v. as Group KD (n = 30) and an equivalent volume of saline as Group C (n = 30) 15 minutes before the induction of anesthesia. Post-operative pain was evaluated using an observational pain score (OPS) on arrival to the post-anesthesia care unit (PACU), at 15, 30, 45, and 60 minutes after that and at 1, 2, 4, 6, 12, and 24 hours after arrival to the ward.
  
  
  RESULTS
  OPS scores were significantly lower at the time of arrival to the PACU, and at 15, 30, 45, and 60 minutes in the Group KD compared with Group C (p < 0.05). Postoperative OPS scores were significantly lower at 1, 2, 4, 6, 12, and 24 hours after operation in Group KD compared with Group C (p < 0.05).
  
  
  CONCLUSIONS
  A prophylactic preoperative single dose of i.v. 0.5 mg/kg dexamethasone in combination with a single dose of i.v. 0.5 mg/kg ketamine significantly decreased post-tonsillectomy pain compare with using i.v. ketamine or i.v. dexamehasone separately.
authors.affiliation: Department of Anesthesiology and Intensive Care, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Safavi
authors.forename: Azim
authors.initials: A
authors.lastname: Honarmand
authors.forename: Mehran Rezvani
authors.initials: MR
authors.lastname: Habibabady
authors.forename: Samira
authors.initials: S
authors.lastname: Baraty
authors.forename: Omid
authors.initials: O
authors.lastname: Aghadavoudi
mesh_terms: D000700:Analgesics / Q000008:administration & dosage*; D000932:Antiemetics / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000008:administration & dosage*; D004435:Eating; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D014068:Tonsillectomy
chemical_list: D000700:Analgesics; D000932:Antiemetics; D007649:Ketamine; D003907:Dexamethasone