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

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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.

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