Pre-Emptive Nebulized Ketamine Versus Pre-Emptive Nebulized Lidocaine For Pain Control After Tonsillectomy In Children With Concurrent Controls

Abstract

BACKGROUND AND AIM

Tonsillectomy is associated with significant pain and post operative pain control is often unsatisfactory. There have been several methods adopted to treat post operative pain but none of the methods were effective, with patients continue to undergo severe postoperative pain. Hence our study aimed at comparing the efficacy of pre emptive nebulized ketamine versus pre-emptive nebulized lidocaine with the control group receiving nebulized saline for pain control in children undergoing tonsillectomy surgeries.

METHODS In this prospective randomized clinical trial, 105 patients with ASA Ⅰ and Ⅱ undergoing tonsillectomy surgery were enrolled and randomized into three groups which are group K, group L, and group C with 35 patients in each group. Patients in each group received nebulized ketamine, lidocaine and normal saline pre emptively. Faces pain scale scores, sedation scale scores, and the usage of rescue analgesia were noted postoperatively for first 6 hours. Hemodynamic parameters were noted before and after nebulization. The main objective was to find the number of patients receiving rescue analgesia postoperatively. RESULTS On comparison of the three groups, rescue analgesia was used less in group K than groups L and C indicating the efficacy of nebulized ketamine, with only 14.3% of patients only received rescue analgesia in group K. whereas in group L and group C, 85.7% and 91.4% patients received rescue analgesia respectively which is significantly higher compared to group K. CONCLUSION Pre-emptive nebulized ketamine was found to be effective in reducing postoperative pain in children undergoing tonsillectomy