Preemptive peritonsillar ketamine infiltration: postoperative analgesic efficacy versus meperidine

Area of Science:

• Anesthesiology
• Pain Management
• Pediatric Surgery

Background:

• Post-tonsillectomy pain is a significant concern impacting recovery and patient satisfaction.
• Effective preemptive analgesia strategies are crucial for pediatric adenotonsillectomy patients.

Purpose of the Study:

• To evaluate the analgesic efficacy of preemptive peritonsillar ketamine infiltration, with or without bupivacaine.
• To compare these interventions against meperidine alone or with bupivacaine for post-tonsillectomy pain management.

Main Methods:

• 100 pediatric patients undergoing adenotonsillectomy were randomized into four groups.
• Groups received peritonsillar infiltration of ketamine, meperidine, or combinations with bupivacaine prior to surgery.
• Postoperative pain was assessed using the Objective Pain Scale (OPS), and recovery metrics including PACU and hospital stay duration were recorded.

Main Results:

• The ketamine-bupivacaine combination (Group K2) demonstrated significantly shorter PACU and hospital stays.
• Group K2 also showed significantly lower OPS scores at 60 and 90 minutes post-admission and higher parental satisfaction.
• Ketamine alone (Group K1) also showed benefits in hospital stay duration compared to meperidine groups.

Conclusions:

• Peritonsillar bupivacaine and ketamine combination provides effective postoperative analgesia and enhances parental satisfaction after adenotonsillectomy.
• This combination is recommended as a routine preemptive analgesic strategy for pediatric adenotonsillectomy.
• The study highlights the benefits of preemptive regional analgesia in pediatric surgical pain management.