title: Comparison of different administration of ketamine and intravenous tramadol hydrochloride for postoperative pain relief and sedation after pediatric tonsillectomy.
abstract: OBJECTIVE
  Tonsillectomy is the oldest and most frequently performed surgical procedure practiced by ear, nose, and throat physicians. In this study, our aim was to compare the analgesic effects of peritonsillar, rectal, as well as intravenous infiltration of ketamine and intravenous tramadol hydrochloride infiltration for postoperative pain relief and sedation after tonsillectomy in children.
  
  
  METHODS
  This randomized controlled study evaluated the effects of peritonsillar, intravenous, and rectal infiltration of ketamine in children undergoing adenotonsillectomy. One hundred twenty children who were categorized under American Society of Anesthesiologists classes I to II were randomized to 4 groups of 30 members each. Group 1 received intravenous (IV) ketamine (0.5 mg/kg), group 2 received rectal ketamine (0.5 mg/kg), group 3 received local peritonsillar ketamine (2 mg/kg), and the control group received IV tramadol hydrochloride infiltration (2 mg/kg). Children's Hospital of Eastern Ontario Pain Scale scores and Wilson sedation scale were recorded at minutes 1, 15, 30, 60 as well as hours 2, 12, and 24 postoperatively. The patients were interviewed on the day after the surgery to assess the postoperative pain and sedation.
  
  
  RESULTS
  All the routes of infiltration of ketamine were as effective as those of tramadol hydrochloride (P > 0.05). A statistically significant difference was observed between IV infiltrations and all groups during the assessments at hours 6 and 24. The analgesic efficacy of IV ketamine was found especially higher at hours 6 and 24 (P(6) = 0.045, P(24) = 0.011).
  
  
  CONCLUSIONS
  Perioperative, low-dose IV, rectal, or peritonsillar ketamine infiltration provides efficient pain relief without any adverse effects in children who would undergo adenotonsillectomy.
authors.affiliation: From the *Otorhinolaryngology Clinic; and †Anesthesiology and Reanimation Clinic, Karaman State Hospital, Karaman, Turkey.
authors.forename: Alper
authors.initials: A
authors.lastname: Yenigun
authors.forename: Tayfun
authors.initials: T
authors.lastname: Et
authors.forename: Sirin
authors.initials: S
authors.lastname: Aytac
authors.forename: Betul
authors.initials: B
authors.lastname: Olcay
mesh_terms: D000233:Adenoidectomy; D061605:Administration, Intravenous; D000285:Administration, Rectal; D000700:Analgesics / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D014068:Tonsillectomy; D014147:Tramadol / Q000008:administration & dosage*
chemical_list: D000700:Analgesics; D014147:Tramadol; D007649:Ketamine