Ketamine alone or ketamine with fentanyl to improve post tonsillectomy analgesia in children

Abstract

Abstract Objectives To evaluate the effects of ketamine used instead of or as an adjuvant to fentanyl on postoperative pain s in children undergoing tonsillectomy. Materiel and Methods: We conducted a double blind prospective randomized study including children, aged between 2 and 7 years, undergoing adenotonsillectomy. Patients were randomly assigned to one of three groups: group G1 received 2 µg/ kg of fentanyl, group G2 received 0.5 mg/ kg of ketamine, and group G3 received fentanyl 1µg/ kg and 0.25 mg / kg of ketamine. We recorded postoperative additional analgesic requirements and side effects. Kruskal-Wallis test was used to compare the unidirectional ordered data between groups. Least-significant difference (LSD) was used to compare the data between two groups. Results Sixty children aged between 2 and 7 years scheduled to undergo adenotonsillectomy were included. Twenty patients were randomly assigned to one of three groups. Better control of pain was noted in group G3, with a significant difference at 30 min compared to both groups G1 (p = 0,008) and G2 (p = 0.036). The need for additional analgesia and side effects were comparable for the three groups. Conclusion ketamine associated with fentanyl provides a satisfactory early analgesia and can even replace fentanyl during tonsillectomy.