In this study, the aim was the evaluation of effect of intravenous (IV) administration of ketamine,\r\nperitonsillar infiltration of tramadol and their combination for control of post-operative pain in comparison\r\nwith single use of each drug in children undergoing tonsillectomy. One hundred and twenty children, aged 2-\r\n15 years, selected for elective adenotonsillectomy were enrolled in the study. We divided the patients into\r\nfour groups of 30 each, Group I: received IV ketamine 0.5 mg/kg, Group II: received peritonsillar infiltration\r\nof tramadol 2 mg/kg, Group III: received IV ketamine 0.5 mg/kg added to peritonsillar tramadol 2 mg/kg and\r\nGroup IV: received IV and peritonsillar infiltration of 0.9% saline. We utilized the Children�s Hospital of\r\nEastern Ontario Pain Scale (CHEOPS) recorded each 15 min after surgery to the first h and then each 2 , 4,\r\n6, 8, 16, 24 h to assess pain levels postoperatively. The analysis of data showed that Group III had\r\nsignificantly lower CHEOPS scores than another three groups (P<0.001), while both Groups I and II had the\r\nsame ranged scores, which were not statistically significant (P>0.05). During 24 h after surgery, the first\r\ntime for analgesic requirement was higher in Group III in comparison with other groups (P<0.001).\r\nCombined use of IV ketamine 0.5 mg/kg with peritonsillar infiltration of tramadol 2 mg/kg provided better\r\nand more prolong analgesic effects compared with using each drug alone in patients undergoing\r\ntonsillectomy.
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