Intravenous and Peritonsillar Infiltration of Ketamine for Postoperative Pain after Adenotonsillectomy: A Randomized Placebo-Controlled Clinical Trial

Objective: To evaluate the efficacy of preoperative intravenous or peritonsillar infiltration of ketamine for postoperative pain control in children following adenotonsillectomy. Patients and Methods: 78 children between 5 and 18 years of age who were scheduled for elective adenotonsillectomy were randomly assigned to four groups: group 1 (n = 19) received intravenous ketamine (0.5 mg/kg), group 2 (n = 21) intravenous normal saline, group 3 (n = 19) ketamine (0.5 mg/kg) injected through the tonsillar capsule, and group 4 (n = 19) normal saline injected in the same location. The incidence of postoperative pain and vomiting as well as the severity of postoperative pain were compared between study groups during the 6-hour postoperative period using a visual analog scale (VAS) at rest, upon swallowing saliva, drinking liquids and eating ice cream. Results: There were no demographic differences between the four groups. The incidence of postoperative pain was significantly lower in groups 1 [7 (36.8%) vs. 10 (47.6%); p = 0.032] and 3 [5 (31.5%) vs. 12 (63.2%); p = 0.001] compared with their controls. The Received: June 9, 2010 Accepted: January 27, 2011 Fariborz Ghaffarpasand 103 Biat Alley, Shuride Shirazi Street PO Box 7173646199 Shiraz, Fars (Iran) Tel. +98 9 173 095 214, E-Mail fariborz_ghaffarpasand @ yahoo.com © 2011 S. Karger AG, Basel 1011–7571/11/0205–0433$38.00/0 Accessible online at: www.karger.com/mpp D ow nl oa de d by : 54 .1 91 .4 0. 80 9 /1 6/ 20 17 9 :0 6: 13 P M