Intraoperative small-dose ketamine does not reduce pain or analgesic consumption during perioperative opioid analgesia in children after tonsillectomy

Batra, Yatindra Kumar; Shamsah, Mohammed; Al-Khasti, M J; Rawdhan, H J F; Al-Qattan, Abdul Rahim; Belani, Kumar G.

doi:10.5414/cpp45155

Cited by 26 publications

(17 citation statements)

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“…This result is not concordant with some other studies (10,11). The discrepancy could be due to higher prevalence of hallucinations and emergence reaction (11.9%) in our study than in similar studies (15,21,26,27). These reactions may have interfered with pain evaluation in the recovery room.…”

Section: Discussioncontrasting

confidence: 93%

Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial

et al. 2012

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AimTo assess the effect of peritonsillar infiltration of ketamine and tramadol on post tonsillectomy pain and compare the side effects.MethodsThe double-blind randomized clinical trial was performed on 126 patients aged 5-12 years who had been scheduled for elective tonsillectomy. The patients were randomly divided into 3 groups to receive either ketamine, tramadol, or placebo. They had American Society of Anesthesiologists physical status class I and II. All patients underwent the same method of anesthesia and surgical procedure. The three groups did not differ according to their age, sex, and duration of anesthesia and surgery. Post operative pain was evaluated using CHEOPS score. Other parameters such as the time to the first request for analgesic, hemodynamic elements, sedation score, nausea, vomiting, and hallucination were also assessed during 12 hours after surgery.ResultsTramadol group had significantly lower pain scores (P = 0.005), significantly longer time to the first request for analgesic (P = 0.001), significantly shorter time to the beginning of liquid regimen (P = 0.001), and lower hemodynamic parameters such as blood pressure (P = 0.001) and heart rate (P = 0.001) than other two groups. Ketamine group had significantly greater presence of hallucinations and negative behavior than tramadol and placebo groups. The groups did not differ significantly in the presence of nausea and vomiting.ConclusionPreoperative peritonsillar infiltration of tramadol can decrease post-tonsillectomy pain, analgesic consumption, and the time to recovery without significant side effects.Registration No: IRCT201103255764N2

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Section: Discussioncontrasting

confidence: 93%

Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial

et al. 2012

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“…Contrary to the studies mentioned above, some other studies (24)(25)(26) have shown that ketamine had no effect in reducing postoperative pain after surgical procedures conducted under general anesthesia, in contrast to the present findings. However, because general anesthesia was not used in the present study, this contradiction was not strict.…”

Section: Discussioncontrasting

confidence: 56%

The effect of orally administered ketamine on requirement for anesthetics and postoperative pain in mandibular molar teeth with irreversible pulpitis

et al. 2011

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Achieving successful anesthesia and pain control in a predictable, efficient manner is a challenge in the endodontic treatment of vital inflamed lower molars. The aim of this study was to evaluate the effect of oral ketamine on the dosage of local anesthetics required and postoperative pain management for irreversibly inflamed mandibular molars. In this randomized double-blind placebocontrolled clinical trial, 36 patients with irreversibly inflamed mandibular molars were randomly divided into two groups of 18. Ten mg of ketamine dissolved in 20 ml of fruit juice was administered orally to patients in the experimental group. The control group was given 20 ml of fruit juice alone as a placebo. After 30 min, inferior alveolar nerve block (IANB) anesthesia was induced using one cartridge of 2% lidocaine and 1:100000 epinephrine. Teeth were tested after 5 to 10 min using an electrical pulp tester. In patients showing a positive response, another IANB injection was applied, and the total number of anesthetic cartridges used was recorded. Postoperative pain was evaluated using a visual analogue scale (VAS). In addition, use of analgesic in the first 24 h after treatment was monitored using a questionnaire. Data were analyzed by t test using SPSS software. There were no significant differences in age or gender between the two groups. The number of anesthetic cartridges used in the ketamine group was significantly less than that in the control group (P = 0.003). Furthermore, postoperative pain in the ketamine group was significantly lower (P = 0.019). Also the number of analgesic tablets taken in the ketamine group was significantly lower (P = 0.011). It can be concluded that a low dose of ketamine might be beneficial for enhancing the effect of local anesthetics. (J Oral Sci 53, 461-465, 2011)

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“…9,12,13 On the other hand, several clinical studies including pediatric trials failed to show an analgesic and/or morphine-sparing effect. [14][15][16] This inconsistency in clinical benefit of ketamine may be caused by the optimal period and regi- Although precise time periods of central sensitization, OIH, and acute tolerance were not clarified, NMDA receptor could be activated throughout the perioperative period. Central sensitization is evoked by repetitive and highfrequency noxious stimulus from C-fibers via activation of NMDA receptor, which could in turn occur by pain stimulation not only during surgery but also at any time in the postoperative period.…”

Section: Discussionmentioning

confidence: 95%

Intra‐ and postoperative low‐dose ketamine for adolescent idiopathic scoliosis surgery: a randomized controlled trial

Minoshima

Kosugi

Nishimura

et al. 2015

Acta Anaesthesiol Scand

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Intraoperative small-dose ketamine does not reduce pain or analgesic consumption during perioperative opioid analgesia in children after tonsillectomy

Cited by 26 publications

References 0 publications

Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial

Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial

The effect of orally administered ketamine on requirement for anesthetics and postoperative pain in mandibular molar teeth with irreversible pulpitis

Intra‐ and postoperative low‐dose ketamine for adolescent idiopathic scoliosis surgery: a randomized controlled trial

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