Clinical pharmacy intervention post tonsillectomy: a randomized control trial.

Background: Pain control in pediatric patients undergoing tonsillectomy remains a dilemma. Tramadol and ketamine are reported to be an effective analgesic.

Objective: To evaluate the effect of peritonsillar infiltration of tramadol in combination with ketamine versus peritonsillar infiltration of tramadol posttonsillectomy.

Methods: Specialty hospital in Jordan. Methods: Sixty children, aged 7-12 years, selected for tonsillectomy were enrolled in the study. We divided the patients into two groups 30 of each, Group I: received peritonsillar saline and peritonsillar infiltration of tramadol 2 mg/kg, Group II: received peritonsillar infiltration of ketamine 1.0 mg/kg added to peritonsillar tramadol 2 mg/kg. Methods: Hemodynamic stability, pain scale, first request of analgesia, total analgesics consumption and post-operative nausea and vomiting (PONV) side effects were recorded 24 h after surgery.

Results: The analysis of data showed that Group II had significantly lower face pain scale, longer time for first request of analgesia, and better hemodynamic stability than GI (p < 0.001). On the other hand the total analgesics requirements, time of surgery, and PONV showed no significant differences between the two groups.

Conclusions: Combined use of peritonsillar infiltration of ketamine 1.0 mg/kg with tramadol 2 mg/kg provided prolong analgesic effects, less pain with no side effect, and better hemodynamic stability compared with using tramadol alone in patients undergoing tonsillectomy.