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Comparison of ketamine and morphine for analgesia after tonsillectomy in children
R J Marcus1, B A Victoria, S C Rushman
1University Dept of Anaesthesia and Pain Management, Leicester Royal Infirmary, UK.
Insights
Ketamine and morphine offer comparable postoperative pain relief for children after tonsillectomy. Ketamine showed a slightly longer recovery time but similar pain scores and side effects compared to morphine.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Postoperative pain management in children undergoing tonsillectomy is crucial.
- Intramuscular (i.m.) ketamine and morphine are commonly used analgesics.
- Evaluating the efficacy and safety of these agents in pediatric patients is important.
Purpose of the Study:
- To compare the effectiveness of i.m. ketamine versus i.m. morphine for postoperative analgesia in children undergoing tonsillectomy.
Main Methods:
- A double-blind, randomized study involving 80 children (aged 6-15 years).
- Participants received either i.m. morphine (0.1-0.15 mg/kg) or i.m. ketamine (0.5-0.6 mg/kg) post-anesthesia induction.
- Pain scores, recovery times, and incidence of side effects were assessed.
Main Results:
- Pain scores were higher in the ketamine group at 30 minutes post-extubation (P < 0.05) but similar thereafter.
- Mean recovery time from anesthesia was significantly longer in the ketamine group (20.1 min) compared to the morphine group (14.2 min) (P < 0.01).
- No significant differences were observed in supplemental analgesia needs, vomiting, or dreaming between groups.
Conclusions:
- Intramuscular ketamine (0.5 mg/kg) can be a viable alternative analgesic for pediatric tonsillectomy.
- While recovery may be slightly prolonged, ketamine provides comparable analgesia and safety profile to morphine in this context.
Abstract:
In a double blind study we compared the effects of i.m. ketamine with morphine on postoperative analgesia in children undergoing tonsillectomy. Eighty children (aged 6-15 yr) were randomized to receive either i.m. morphine 0.1-0.15 mg kg-1 or ketamine 0.5-0.6 mg kg-1, after induction of a standard general anaesthetic. Pain scores 30 min after extubation were higher (P < 0.05) in the ketamine group, but were similar thereafter to the morphine group. Mean (SD) times to recovery from anaesthesia were 20.1 (SD 6.5) min in the ketamine group compared to 14.2 (5.6) min in the morphine group (P < 0.01). There were no differences in supplemental analgesia requirements, or the incidence of vomiting or dreaming between the groups. We conclude that ketamine 0.5 mg kg-1 i.m. may be an alternative analgesic for children undergoing tonsillectomy.