Pain Relief for Children after Adenotonsillectomy

• Published in: Journal of international medical research 2006-11, Vol.34 (6), p.648-654
• Main Authors: Ertugrul, F, Akbas, M, Karsli, B, Kayacan, N, Bulut, F, Trakya, A
• Format: Article
• Language: English
• Subjects: Analgesics - administration & dosage; Analgesics - therapeutic use; Child; Child, Preschool; Female; Humans; Infant; Ketamine - administration & dosage; Ketamine - therapeutic use; Male; Meperidine - administration & dosage; Meperidine - therapeutic use; Pain, Postoperative - drug therapy; Tonsillectomy - adverse effects; Tramadol - administration & dosage; Tramadol - therapeutic use
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/147323000603400610

Effective pain relief following adenotonsillectomy in children remains a challenge. This study evaluated the effects of intramuscular 0.5 mg/kg ketamine, 1 mg/kg tramadol or 1 mg/kg meperidine on post-operative pain and recovery in 45 children aged 1-7 years undergoing adenotonsillectomy. Anaesthesia was induced with thiopental or sevoflurane (with succinylcholine for intubation) and was maintained with sevoflurane in oxygen and nitrous oxide. Post-operative pain was scored blind using a modified Toddler–Preschooler Post-Operative Pain Scale 30, 60, 120 and 240 min after tracheal extubation. Post-operative agitation scores were also recorded. Mean post-operative pain score was significantly higher in the tramadol-treated group compared with the meperidine-treated group 120 min after extubation. At all other time-points after extubation, mean post-operative pain scores were similar for the three treatment groups. Ketamine was associated with a significantly higher mean agitation score compared with tramadol and meperidine. We conclude that the effects of ketamine, meperidine and tramadol on post-operative pain following adenotonsillectomy in children were similar.