The effect of using pre-operative ketamine injection on post-tonsillectomy pain intensity in children

Introduction: Tonsillectomy in children is associated with some major complications originating from intense post-tonsillectomy pain which can distress patients, cause swallowing difficulties and discomfort, and also lead to aspiration. Thus, this study aimed to investigate the effect of using pre-operative ketamine injection on post-tonsillectomy pain intensity in children. Methods: This double-blind clinical trial was carried out on 60 patients undergoing elective tonsillectomy. To this end, all the patients were anaesthetized by the same method. In the first group, 2 cc of ketamine (0.5mg/kg) solution was topically injected into the soft tissue of tonsillar fossa (peritonsillar space); in the second group, a similar administration was performed but with normal saline. For all the patients, incision was made 5 minutes after injection with the Blast Dissection Snare method. Moreover, the patients’ pain intensity and analgesics consumption were measured 30 minutes, and 1, 2, 4, and 6 hours after surgery. Finally, the collected data were analyzed using the SPSS software. Results: The present study was conducted on 60 patients, 37 males and 23 females, with the mean age of 9.3±3.4 years. In this respect, repeated measures analysis of variance of patients’ pain scores collected in five post-operative stages showed that pain intensity in both groups was at the highest level immediately after operation; it gradually decreased during measurement stages. However, at each measurement, the pain intensity experienced in the ketamine-treated group was significantly lower than that for the placebo group. Conclusion: It was concluded that pre-incision topical injection of ketamine can serve as an effective method to control post-tonsillectomy throat pain.