title: Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial.
abstract: OBJECTIVE
  To assess the effect of peritonsillar infiltration of ketamine and tramadol on post tonsillectomy pain and compare the side effects.
  
  
  METHODS
  The double-blind randomized clinical trial was performed on 126 patients aged 5-12 years who had been scheduled for elective tonsillectomy. The patients were randomly divided into 3 groups to receive either ketamine, tramadol, or placebo. They had American Society of Anesthesiologists physical status class I and II. All patients underwent the same method of anesthesia and surgical procedure. The three groups did not differ according to their age, sex, and duration of anesthesia and surgery. Post operative pain was evaluated using CHEOPS score. Other parameters such as the time to the first request for analgesic, hemodynamic elements, sedation score, nausea, vomiting, and hallucination were also assessed during 12 hours after surgery.
  
  
  RESULTS
  Tramadol group had significantly lower pain scores (P=0.005), significantly longer time to the first request for analgesic (P=0.001), significantly shorter time to the beginning of liquid regimen (P=0.001), and lower hemodynamic parameters such as blood pressure (P=0.001) and heart rate (P=0.001) than other two groups. Ketamine group had significantly greater presence of hallucinations and negative behavior than tramadol and placebo groups. The groups did not differ significantly in the presence of nausea and vomiting.
  
  
  CONCLUSIONS
  Preoperative peritonsillar infiltration of tramadol can decrease post-tonsillectomy pain, analgesic consumption, and the time to recovery without significant side effects.
authors.affiliation: Department of Anesthesiology, Shahid Sadoughi Hospital, Bou ali BLVD, 8916886938 Yazd, Iran.
authors.forename: Vida
authors.initials: V
authors.lastname: Ayatollahi
authors.forename: Shokoufeh
authors.initials: S
authors.lastname: Behdad
authors.forename: Maryam
authors.initials: M
authors.lastname: Hatami
authors.forename: Hossein
authors.initials: H
authors.lastname: Moshtaghiun
authors.forename: Behnam
authors.initials: B
authors.lastname: Baghianimoghadam
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D014068:Tonsillectomy; D014147:Tramadol / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000778:Anesthetics, Dissociative; D014147:Tramadol; D007649:Ketamine