title: The comparison of preincisional peritonsillar infiltration of ketamine and tramadol for postoperative pain relief on children following adenotonsillectomy.
abstract: OBJECTIVE
  To investigate and compare the effectiveness of preincisional peritonsillar infiltration of ketamine and tramadol for post-operative pain on children following adenotonsillectomy.
  
  
  METHODS
  Prospective randomized double blind controlled study.
  
  
  METHODS
  Seventy-five children aged 3-10 years undergoing adenotonsillectomy were included in study. Patients received injections in peritonsillar fossa of tramadol (2 mg/kg-2 ml), ketamine (0.5 mg/kg-2 ml) or 2 ml serum physiologic. During operation heart rate, oxygen saturation, average mean blood pressures were recorded in every 5 min. Operation, anesthesia and the time that Alderete scores 9-10, patient satisfaction, analgesic requirements were recorded. Postoperatively nausea, vomiting, sedation, dysphagia, bleeding scores were recorded at 0, 10, 30, 60 min and 2, 4, 8, 12, 18, 24h postoperatively. Pain was evaluated using modified Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) at fixed intervals after the procedure (15 min and 1, 4, 12, 16, and 24h postoperatively).
  
  
  RESULTS
  The recordings of heart rate, mean arterial pressure, nausea, vomiting, sedation and bleeding scores were similar in all groups (p>0.05). The mCHEOPS scores at 10 min, 30 min, 1h, 8h were significantly lower in both tramadol and ketamine group when compared with control (p<0.05). Use of additional analgesia at 10 min and 18 h were higher in control group than ketamine, tramadol group (p<0.05). Dysphagia scores were significantly lower for both ketamine and tramadol group when compared with control group (p<0.05). mCHEOPS, additional analgesia, dysphagia, patient satisfaction scores were similar in tramadol, ketamine groups (p>0.05).
  
  
  CONCLUSIONS
  Preincisional injection of ketamine and tramadol prior to tonsillectomy is safe, effective method and equivalent for post-tonsillectomy pain, patient satisfaction, postoperative nausea, vomiting, dysphagia.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Turgut Ozal University Hospital, Ankara, Turkey. Electronic address: kserifeboynukalin@yahoo.com.
authors.forename: Kadriye Serife
authors.initials: KS
authors.lastname: Ugur
authors.forename: Safinaz
authors.initials: S
authors.lastname: Karabayirli
authors.forename: Rüveyda İrem
authors.initials: Rİ
authors.lastname: Demircioğlu
authors.forename: Nebil
authors.initials: N
authors.lastname: Ark
authors.forename: Hanifi
authors.initials: H
authors.lastname: Kurtaran
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Muslu
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Sert
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000772:Anesthesia, Local / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*; D014147:Tramadol / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid; D014147:Tramadol; D007649:Ketamine
keywords: Children; Ketamine; Pain; Tonsillectomy; Tramadol