the comparision of effects intraoperative tramadol and ketamine usage for postoperative pain relief in patient with tonsillectomy

Abstract

We aimed to compare effects of ketamine and tramadol administered intraoperatively on postoperative pain and analgesic demand in children undergoing tonsillectomy operations.
Ninety children undergoing tonsillectomy, aging 5-15 years old, ASA I - II admitted in this study. Cases were arranged in three groups and they were given stadardized general anaesthesia. After coagulation, ketamine 0,5 mg.kg-1 intravenously (iv) in ketamine group, 2 mg.kg-1 tramadol iv in tramadol group and serume physiologic iv in control group were given. Duration of anaesthesia, operation and stay in PACU were recorded. NRS and CHEOPS scales were used to assess postoperative pain. Paracetamol, 15 mg.kg-1, was given rectally in the first 6 hours (hrs) and orally over 6 hrs, if NRS greater than 3 and CHEOPS greater than 8 were assessed. All data were recorded concerning with the first, total dosage of analgesic and complications. within 24 hrs.
Demographic data, duration of anaesthesia, operation and stay in PACU were similar between groups (p>0.05). Number of patients required additive analgesic were higher in control group. No differences were found between tramadol and ketamine groups (p>0.05). The time additive analgesic given was earlier in control group (p<0.05), but similar in tramadol and ketamine groups (p>0.05). Paracetamol dosage was significantly higher in control group (p<0.05), but similar between tramadol and ketamine groups (p>0.05). Frequency of nausea and vomiting was found significantly higher in tramadol and ketamine groups (p<0.05).
Postoperative pain was effectively managed using 2 mg.kg-1 tramadol and 0,5 mg.kg-1 ketamine in pediatric tonsillectomies.