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Updated: Jul 8, 2026

CO2-Lasertonsillotomy Under Local Anesthesia in Adults
05:07

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

Topical ketamine and morphine for post-tonsillectomy pain.

O Canbay1, N Celebi, S Uzun

  • 1Hacettepe University, Faculty of Medicine, Department of Anaesthesiology, Sihhiye, Ankara, Turkey. ozgurcanbay@yahoo.com

European Journal of Anaesthesiology
|January 12, 2008
PubMed
Summary

Topical ketamine and morphine oral rinse effectively reduced pain after tonsillectomy in children. This safe and easy analgesic approach decreased pain scores and 24-hour analgesic consumption compared to a control group.

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Last Updated: Jul 8, 2026

CO2-Lasertonsillotomy Under Local Anesthesia in Adults
05:07

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Post-tonsillectomy pain is a significant clinical challenge, often requiring substantial opioid and non-opioid analgesics.
  • Current pain relief strategies for tonsillectomy remain a clinical dilemma despite various surgical and anesthetic techniques.
  • Effective and safe pain management following adenotonsillectomy is crucial for pediatric patient recovery.

Purpose of the Study:

  • To evaluate the efficacy of topically administered ketamine and morphine via oral rinse for post-tonsillectomy pain relief.
  • To assess the impact of topical analgesics on pain scores, nausea, vomiting, sedation, and bleeding.
  • To determine if a combination of ketamine and morphine offers superior analgesia compared to individual agents or placebo.

Main Methods:

  • A randomized controlled trial involving 60 children aged 3-12 years undergoing tonsillectomy.
  • Four groups were established: topical ketamine, topical morphine, topical ketamine + morphine, and a control (artificial saliva).
  • Study drugs were administered as an oral rinse to the tonsillar fossae for 5 minutes, with pain, nausea, vomiting, sedation, and bleeding assessed postoperatively.

Main Results:

  • The control group exhibited significantly higher pain scores upon arrival in the recovery ward.
  • Both the ketamine and morphine groups demonstrated longer effective analgesia durations compared to the combined ketamine-morphine and control groups.
  • The 24-hour analgesic consumption was notably higher in the control group, indicating reduced need for systemic analgesics in the treatment groups.

Conclusions:

  • Topical ketamine and morphine administered as an oral rinse represent a safe and straightforward method for managing adenotonsillectomy pain.
  • This topical analgesic strategy appears effective in reducing postoperative pain intensity and the overall requirement for systemic pain medication.
  • The findings suggest a promising non-invasive approach to improve pediatric tonsillectomy recovery outcomes.