Comparison between peritonsillar infiltration of ketamine or bupivacaine for post-tonsillectomy analgesia

Document Type : Original Article

Authors

1 Department of Anesthesia and Intensive Care, Faculty of Medicine, Sohag University, Egypt.

2 Department of ENT Surgery, Faculty of Medicine, Sohag University, Egypt.

Abstract

Background: Managing post-tonsillectomy pain is crucial for promoting oral intake and hydration while minimizing irritability and discomfort, which can increase the risk of postoperative bleeding. Objectives: To compare the efficacy of pre-incisional peri-tonsillar infiltration of bupivacaine vs. ketamine in achieving postoperative analgesia following tonsillectomy or adenotonsillectomy. Methods: Eighty patients aged 3 to 17 years, scheduled for tonsillectomy or adenotonsillectomy, were divided into two equal groups based on the agent used for pre-incisional peritonsillar infiltration to attain postoperative analgesia. In group B, patients received 5 ml of bupivacaine 0.5%, while group K received infiltration with ketamine at a dose of 0.5 mg/kg. Results: There was no significant difference between the two groups concerning the modified objective pain scale (MOPS) (P value 0.475) or total analgesic consumption during the first 12 hours postoperatively (P > 0.05). Additionally, no significant difference was noted in the modified Aldrete score between the two groups (P value 0.534); however, a significant reduction in the Wilson sedation score was observed in the ketamine group (P value 0.006). The occurrence of postoperative complications did not significantly differ between the groups (P > 0.05). Conclusion: Pre-incisional peri-tonsillar infiltration of either bupivacaine or ketamine can be safely and effectively used to manage post-tonsillectomy pain, demonstrating nearly equal effects on post-anesthesia recovery time and total postoperative analgesic consumption.

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