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. 2023 Jul-Sep;13(3):84-90.
doi: 10.4103/jwas.jwas_31_23. Epub 2023 Jun 27.

Evaluation of the Effects of Peritonsillar Infiltration of Tramadol-Ketamine Combination Versus Tramadol Alone on Posttonsillectomy Pain in Children

Samuel Isaiah Nuhu  1 , Daniel Francis Atteh  1 , Henry Yammoh Embu  1 , Erdoo Suckie Isamade  1 , Daniel Damasau Kokong  2 , Nuhu Danle Ma'an  2 , Kefas Thomas Malau  1 , Yohanna Musa Usman  3
Affiliations

Evaluation of the Effects of Peritonsillar Infiltration of Tramadol-Ketamine Combination Versus Tramadol Alone on Posttonsillectomy Pain in Children

Samuel Isaiah Nuhu et al. J West Afr Coll Surg. 2023 Jul-Sep.

Abstract

Introduction: Tonsillectomy is associated with significant pain and post-operative pain control is often unsatisfactory. This study sought to evaluate the effect of peritonsillar infiltration of tramadol-ketamine combination, tramadol alone and ketamine alone on post-tonsillectomy pain in children.

Patients and methods: A randomized double-blinded interventional study involving 90 patients aged 3-15 years of American society of anesthesiologists I or II physical status scheduled for elective adenoidectomy, tonsillectomy or adenotonsillectomy at JUTH was conducted. Patients were randomized into one of three groups: group I received tramadol 2mg/kg, group II received ketamine 1mg/kg plus tramadol 2mg/kg and group III received ketamine 1mg/kg only all made up to 2mls with normal saline and 1ml given per tonsillar bed. All patients had standard general anaesthesia with endotracheal intubation and monitoring. Data was analyzed using Epi-info version 7.1.5 with p £ 0.05.

Result: The analysis of data showed that the mean ages of the participants in group I, II and III were 5.70±2.00, 5.69±3.22 and 4.47±2.01 years respectively (p-value=0.091). Group II had significantly lower pain scores, longer time to first request of analgesia, earlier oral intake and discharge from the hospital compared to the group that received either tramadol or ketamine alone. Minimal side effects were noted across all the groups in the study.

Conclusion: Peri-tonsillar infiltration of tramadol-ketamine combination immediately after tonsillectomy (but before extubation of patients) significantly decreased post-tonsillectomy pain without increasing the incidence of side effects compared to tramadol or ketamine alone in children undergoing adenotonsillectomy.

Keywords: Adenotonsillectomy; ketamine; peritonsillar infiltration; postoperative pain; tramadol.

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Conflict of interest statement

There are no conflicts of interest.

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