The comparison of the effect of oral administration and peritonsillar injection of ketamine on pain relief and the related complications following tonsillectomy operation

Pain following tonsillectomy is common in children, and its elimination due to its subsequent complications is essential. Therefore, this study was conducted with the aim of obtaining the best method of administering ketamine for reducing pain following tonsillectomy with the greatest efficiency and the least side effects. This study was a double-blind clinical trial which was conducted on 92 children, aged 3-9, who had been admitted for tonsillectomy. The patients were randomly divided into oral ketamine and ketamine injection groups (each containing 46 patients). Thirty minutes before the operation, all the patients were given apple-juice; ketamine injection group received normal apple juice without ketamine, whereas the oral ketamine group received 5mg/kg ketamine with the apple juice. Three minutes before tonsillectomy, 0.5 mg/kg ketamine was injected to the peritonsillar area in ketamine injection group while the same volume of saline was injected to the oral ketamine group. Data were registered, gathered, and, then, analyzed using Wilcoxon, Man Whitney, and t tests. Demographic data and blood pressure before and after the operation did not have significant differences in the 2 groups. In terms of the duration of operation time, a significant difference was observed between the two groups; the operation time in the ketamine injection group was shorter (p=0.006). Also, pain score in the ketamine injection group was less than the oral ketamine group. Ketamine is effective in reducing the pain after tonsillectomy operation. Peritonsillar injection of ketamine is more effective than its oral usage.