Efficacy of peritonsillar infilltration of ketamine, tramadol, and lidocaine for prevention of post tonsillectomy pain

Abstract

Backgrounds: Tonsillectomy is one of the most common surgeries in children. Controlling pain after tonsillectomy is still controversial. In this study, the efficacy of peritonsillar injection of lidocaine, tramadol, ketamine,and placebo is compared on post tonsillectomy pain.

Methods: In a randomized double-blind clinical trial, 120 patients referring for tonsillectomy to Imam Khomeini hospital in Ahvaz, Iran were recruited into four groups: ketamine, tramadol, lidocaine,and normal saline. One milliliter of medications was injected in each tonsil.Surgery was performed by a surgeon with sharp dissection technique without electrocautery. Pain was recorded 1, 4, 8, 16, and 24 hour(s) after the operation.

Results: Baseline characteristics such as age, sex,weight, height,and surgery and anesthesia time did not differ significantly among four groups. Pain scores decreased over time in all groups. No significant difference was observed among ketamine, tramadol, lidocaine,and placebo regarding pain quantity, surgery time, the first time of analgesic requirement,hospital stay,and beginning liquid diet.

Conclusion: Local injection of ketamine, tramadol, and lidocaine were not significantly different from placebo for prevention of pain in the first 24 hours after tonsillectomy.

Keywords: Tonsillectomy,pain,lidocaine,tramadol,ketamine