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Ketamine peritonsillar infiltration during tonsillectomy in pediatric patients: An updated meta-analysis

Yao Tong1, Xi-Bing Ding1, Xin Wang2

  • 1Department of Anesthesiology, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai 200120, China.

International Journal of Pediatric Otorhinolaryngology
|August 21, 2014
PubMed

Insights

Peri-operative ketamine peritonsillar infiltration in children effectively reduces postoperative pain and nausea within one hour after tonsillectomy. This method also decreases the need for additional analgesics but does not impact pain at 120 minutes.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Peri-operative ketamine peritonsillar infiltration is used in pediatric tonsillectomy to manage postoperative nausea and vomiting (PONV).
  • Previous meta-analyses were inconclusive due to limited data regarding ketamine's efficacy.
  • Updated meta-analysis needed to confirm ketamine's role in pediatric tonsillectomy.

Purpose of the Study:

  • To evaluate the effectiveness of ketamine peritonsillar infiltration for pain relief in pediatric tonsillectomy.
  • To assess the impact of ketamine on analgesic requirements and PONV incidence.
  • To update previous meta-analyses with current randomized controlled trial data.

Main Methods:

  • Systematic review and meta-analysis of ten randomized controlled trials.
  • Inclusion of 522 pediatric patients undergoing tonsillectomy.
  • Pain intensity measured using the modified CHEOPS score.

Main Results:

  • Ketamine significantly reduced pain scores at 30 and 60 minutes post-surgery (WMD -1.20 and -1.71, respectively).
  • Reduced analgesic requirements (RR 0.51) and lower incidence of PONV (RR 0.73) observed in the ketamine group.
  • No significant differences in operation time, anesthesia time, first analgesic time, or pain scores at 120 minutes.

Conclusions:

  • Ketamine peritonsillar infiltration provides short-term postoperative analgesia (within 1 hour) after pediatric tonsillectomy.
  • Ketamine reduces the need for analgesics and lowers PONV incidence.
  • No prolonged analgesic effect or impact on first analgesic time was observed.
Abstract

Keywords:
KetamineMeta-analysisPostoperative pain reliefTonsillectomy

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