Comparison of topical ropivacaine with and without ketamine on post-surgical pain in children undergoing tonsillectomy: a randomized controlled double-blind study

Hong, Boohwi; Lim, Chang Su; Kim, Chongam; Lee, Jung Un; Kim, Yong Min; Jung, Choonho; Jo, Yumin

doi:10.1007/s00540-017-2353-z

Cited by 14 publications

(8 citation statements)

References 31 publications

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“…A total of 189 randomized controlled and comparison trials met the inclusion criteria for analysis 18–206 . A PRISMA diagram outlining the literature search is shown in Figure 1, and the risk of bias graph is shown in Figure 2.…”

Section: Resultsmentioning

confidence: 99%

A scoping review of randomized clinical trials for pain management in pediatric tonsillectomy and adenotonsillectomy

Shih

Long

Pecha

et al. 2022

World j. otorhinolaryngol.-head neck surg.

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Section: Resultsmentioning

confidence: 99%

A scoping review of randomized clinical trials for pain management in pediatric tonsillectomy and adenotonsillectomy

Shih

Long

Pecha

et al. 2022

World j. otorhinolaryngol.-head neck surg.

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“…The addition of ketamine to ropivacaine for local tonsillar application was associated with better postoperative analgesia compared to the application of ropivacaine alone. 23 Dal et al 24 proved that locally injected ketamine effectively reduced pain scores in patients undergoing adenotonsillectomy. However, in a recent prospect guideline for post-tonsillectomy pain management, Aldalmulij et al 25 did not recommend the use of ketamine infiltration in children due to the risk of systemic side effects after absorption, although different studies consistently concluded that it was effective in reducing pain and analgesic requirements after tonsillectomy in children.…”

Section: Discussionmentioning

confidence: 99%

Ketamine infiltration decreases the need for opioids after thyroid surgery

et al. 2023

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Background: Postoperative pain increases the risk of postoperative complications and may predispose patients to chronic post-surgical pain. This study aims to evaluate the impact of ketamine wound infiltration versus placebo at the end of thyroid surgery on postoperative pain and analgesic requirements. Methods: In this randomized controlled trial, we prospectively studied patients who underwent thyroid surgery. Patients were randomized into two groups: group S, where local infiltration was performed using 10 ml of a physiological saline solution; and group K, where 10 ml of a solution containing 2 mg/kg ketamine was infiltrated. Standardized thyroidectomies were performed in the 2 groups. Pain perception was measured using a visual analog scale (VAS) every 10 minutes in the post-anesthetic care unit (PACU) for 2 hours and thereafter every 6 hours during the first 24 hours. The opioid requirement in the PACU was evaluated. A comparison between the 2 groups was carried out. Results: Postoperatively, the mean VAS was higher in group S compared to group K during all PACU stay periods and the first 24 hours. Pain scores during swallowing were significantly lower for group K in the PACU at 0, 10, and 20 minutes. The mean morphine consumption in the PACU was 0.71 mg and 0 mg respectively in group S and group K (p=0.03). The incidence of nausea and vomiting was similar in both groups. Conclusions: Ketamine wound infiltration is an efficient modality to reduce postoperative opioid consumption compared to a placebo after thyroid surgery.

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“…It increases the systemic vascular resistance, decreasing the venous return and, hence, decreases the shunting of blood in the heart [41]. It is used widely for head and neck surgeries like tonsillectomies, cleft palate repair operations, and dental procedures [42][43][44]. Studies suggest that it can be used in surgeries for traumatic brain injuries with increased intracranial pressure (ICP) since it decreases ICP without decreasing the systemic BP and cerebral perfusion [22].…”

Section: Anesthetic Usesmentioning

confidence: 99%

Clinical Uses of Ketamine in Children: A Narrative Review

Bali¹,

Dang²,

Gonzalez³

et al. 2022

Cureus

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Ketamine is a phencyclidine derivative that acts as a noncompetitive N-methyl-D-aspartate as well as a glutamate receptor antagonist. It also has other minor mechanisms that contribute to its extensive drug profile. Ketamine is a bronchodilator and maintains normal airway reflexes and, thus, permits spontaneous respiration. This, coupled with the fact that it produces potent analgesia, makes it highly suitable for children.Despite its many merits, the drug's side effects, along with its cultural image of being a drug of abuse, a drug used in veterinary medicine, or a "date-rape drug" have sullied its reputation within the armamentarium of medicine. Even though it is widely used in developing countries, its use in Western nations has diminished. We have strived to explore the various clinical uses of ketamine in children through this article. In addition, the article also highlights how some of the fears associated with using the drug are unfounded and provides ways by which the drug's side effects can be prevented and managed.

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Comparison of topical ropivacaine with and without ketamine on post-surgical pain in children undergoing tonsillectomy: a randomized controlled double-blind study

Abstract: Topical ropivacaine with ketamine can reduce immediate postoperative pain and analgesic requirement better than ropivacaine alone.

Cited by 14 publications

References 31 publications

A scoping review of randomized clinical trials for pain management in pediatric tonsillectomy and adenotonsillectomy

A scoping review of randomized clinical trials for pain management in pediatric tonsillectomy and adenotonsillectomy

Ketamine infiltration decreases the need for opioids after thyroid surgery

Clinical Uses of Ketamine in Children: A Narrative Review

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