title: Clinical pharmacy intervention post tonsillectomy: a randomized control trial.
abstract: BACKGROUND
  Pain control in pediatric patients undergoing tonsillectomy remains a dilemma. Tramadol and ketamine are reported to be an effective analgesic.
  
  
  OBJECTIVE
  To evaluate the effect of peritonsillar infiltration of tramadol in combination with ketamine versus peritonsillar infiltration of tramadol posttonsillectomy.
  
  
  METHODS
  Specialty hospital in Jordan.
  
  
  METHODS
  Sixty children, aged 7-12 years, selected for tonsillectomy were enrolled in the study. We divided the patients into two groups 30 of each, Group I: received peritonsillar saline and peritonsillar infiltration of tramadol 2 mg/kg, Group II: received peritonsillar infiltration of ketamine 1.0 mg/kg added to peritonsillar tramadol 2 mg/kg.
  
  
  METHODS
  Hemodynamic stability, pain scale, first request of analgesia, total analgesics consumption and post-operative nausea and vomiting (PONV) side effects were recorded 24 h after surgery.
  
  
  RESULTS
  The analysis of data showed that Group II had significantly lower face pain scale, longer time for first request of analgesia, and better hemodynamic stability than GI (p < 0.001). On the other hand the total analgesics requirements, time of surgery, and PONV showed no significant differences between the two groups.
  
  
  CONCLUSIONS
  Combined use of peritonsillar infiltration of ketamine 1.0 mg/kg with tramadol 2 mg/kg provided prolong analgesic effects, less pain with no side effect, and better hemodynamic stability compared with using tramadol alone in patients undergoing tonsillectomy.
authors.affiliation: Faculty of Pharmacy, Philadelphia University, P.O. Box 1, Amman, 19392, Jordan, Bushra_abdul@yahoo.com.
authors.forename: Bushra Abdul
authors.initials: BA
authors.lastname: Hadi
authors.forename: Saleh M
authors.initials: SM
authors.lastname: Sbeitan
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage; D002648:Child; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods / Q000639:trends; D010149:Postoperative Pain / Q000175:diagnosis / Q000517:prevention & control*; D010595:Pharmacists / Q000639:trends; D010607:Pharmacy Service, Hospital / Q000379:methods / Q000639:trends; D014068:Tonsillectomy / Q000009:adverse effects* / Q000639:trends; D014147:Tramadol / Q000008:administration & dosage*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol; D007649:Ketamine