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Comparing Preemptive Ketamine Nebulization and Intravenous Ketamine for Post-Operative Analgesia in Children Undergoing Tonsillectomy
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P Deshmukh    , M Hanagandi , P Gadvi , C Kamat , R Kerur * |
| 1.Department of Anaesthesia, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (KAHER), Karnataka, India. , ravikerur@gmail.com |
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Abstract: (813 Views) |
Background and Objective: Tonsillectomy is a common surgical procedure performed in children to remove enlarged or infected tonsils. Postoperative pain management is crucial to ensure the smooth recovery and to prevent complications in pediatric patients undergoing tonsillectomy. This study aims to compare the effectiveness of preemptive ketamine nebulization versus intravenous injection of ketamine for pain relief in 5-10-year-old children undergoing tonsillectomy.
Methods: In this randomized controlled trial, 64 children, after ethical and parental approvals, were split into two groups. Both groups received glycopyrrolate (5 mcg/kg). One group had ketamine nebulization (1 mg/kg) 20 minutes before surgery, and the other received intravenous ketamine (1 mg/kg) just before entering the operating room. Pain levels were assessed using a verbal rating scale after surgery and one hour later. The time for first rescue analgesia was noted for both the groups. Parental separation scores and sedation levels were evaluated using a 5-Point sedation scale before the operation.
Findings: Following the surgery, there were no notable differences in pain scores between the groups in the Post Intensive Care Unit (PICU). However, one-hour after surgery, the ketamine nebulization group exhibited significantly lower pain scores (p<0.05) compared to the intravenous ketamine group. Moreover, the ketamine nebulization group had a significantly longer duration until the first rescue analgesia was needed (300±26.396 minutes) compared to the intravenous ketamine group (237.187±34.382 minutes) (p<0.05). Parental Separation Score and Sedation Score were similar in the two groups.
Conclusion: According to results, administering ketamine nebulization significantly prolongs the duration of pain relief compared to intravenous ketamine for tonsillectomy. Therefore, nebulization can be considered as an alternative method for administering ketamine.
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| Keywords: Ketamine Nebulization, Intravenous Ketamine, Post-Operative Analgesia, Tonsillectomy. |
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Full-Text [PDF 249 kb]
(95 Downloads)
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Type of Study: Research |
Subject:
Pediatric Surgery
Received: 2023/07/31 | Accepted: 2024/03/2 | Published: 2025/04/30
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