Ketamine and Paracetamol versus Paracetamol efficacy for Pediatric Adenotonsillectomy
A major concern for the anesthesiologists is the management of posttonsillectomy pain and agitation resulting from tonsillectomy which is the most common surgeries among children. Thus, this study focus on the management of postoperative pain in tonsillectomy for effectiveness of a dose of ketamine combined with paracetamol and paracetamol alone.
The patients were randomly divided into two groups: the ketamine and control. 15 minutes before the termination of surgery in both groups, intravenous (IV) paracetamol infusion (15 mg/kg) was initiated. It continued further with the IV injection of ketamine (0.25 mg/kg) in the ketamine group and an equal volume of saline in the control group. After the operation, the children's hospital of eastern Ontario (CHEOPS) pain scale was used to assess the symptoms. The pain and agitation score and also the incidence of nausea and vomiting were noted in 0.5, 6 and 12 hours after the operation. Using the SPSS software version 16 the data was analyzed. Statistically important P value of less than 0.05 was reviewed in all the cases.
In the two groups considering the demographic data (age, sex distribution, weight and height), no significant difference between them was observed. Ketamine group had lower CHEOPS pain scales than the control group at 0.5 and 6 hours after the surgery (P = 0.003 and P = 0.023). Between the two groups, there was no outstanding difference in the CHEOPS scale at 12 hours after the surgery, dose of adjuvant analgesic and the incidence of nausea and vomiting prior surgery. As a result, postoperative analgesia in children was enhanced in the ketamine group.Thus, low-dose ketamine administration with paracetamol is recommended for better management of posttonsillectomy pain.