title: Ketamine improves postoperative pain and emergence agitation following adenotonsillectomy in children. A randomized clinical trial.
abstract: BACKGROUND
  Management of postoperative pain and emergence agitation following adenotonsillectomy in pediatrics has been a major challenge for anesthesiologists. Although analgesic sparing effect of ketamine has been studied during tonsillectomy in pediatrics, there is a lot of controversy about its efficacy. Present study was designed to evaluate the effect of intravenous low dose ketamine (0.25 mg/kg) during induction of anesthesia on postoperative pain and emergence agitation following adenotonsillectomy in children.
  
  
  METHODS
  In this randomized clinical trial 66 children aged 5 to 15 years who underwent elective adenotonsillectomy were randomly allocated into two groups. Patients in the control group received 5 ml of normal saline while patients in the ketamine group received 0.25 mg/kg of ketamine in 5 ml volume during induction of anesthesia. After termination of surgeries and transferring the patients to recovery, emergence agitation, pain score, paracetamol requirements and incidence of postoperative nausea & vomiting were assessed every hour for 6 hours.
  
  
  RESULTS
  Emergence agitation score was significantly lower in the ketamine group (P = 0.002). Pain score at all hours was lower in the ketamine group than the control group (P < 0.05). The requirements for intravenous paracetamol were significantly lower in the ketamine group (P = 0.0036). There was no difference in the incidence of postoperative nausea and vomiting between the two groups (P = 0.99).
  
  
  CONCLUSIONS
  Low-dose ketamine during induction of anesthesia improves emergence agitation and postoperative pain following adenotonsillectomy in children.
authors.affiliation: Shiraz Anesthesiology and Intensive Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Eghbal
authors.forename: Shujaulhagh
authors.initials: S
authors.lastname: Taregh
authors.forename: Ayeh
authors.initials: A
authors.lastname: Amin
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Sahmeddini
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000293:Adolescent; D017109:Akathisia, Drug-Induced / Q000209:etiology*; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000762:Anesthesia Recovery Period; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D007649:Ketamine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D010147:Pain Measurement / Q000379:methods / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting; D011446:Prospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D012965:Sodium Chloride; D007649:Ketamine