Journal of Emergency Health Care

en The Impact of Local Ketamine Injection at the Tonsillectomy Site on Postoperative Pain Reduction in Patients Under 18: A Double-Blind Clinical Trial عمومى General پژوهشي Research Background and Purpose: Tonsillectomy is a common procedure for treating tonsil-related conditions, but it can lead to significant postoperative pain and complications. Effective pain management and anxiety reduction are critical in pediatric care. Current standard treatments, including injectable acetaminophen and opioids, have limitations. Ketamine, known for its analgesic and antihyperalgesic effects, has demonstrated efficacy in reducing postoperative pain and minimizing opioid use in both adults and children. This study evaluates the effectiveness of a local ketamine injection at the tonsillectomy site in alleviating postoperative pain in patients under 18 years of age through a double-blind, randomized clinical trial. Materials and Methods: This randomized, double-blind, controlled trial was conducted at the Bo Ali Sina Sari Medical Training Center between 2022 and 2023. Sixty pediatric patients scheduled for tonsillectomy were randomly assigned to either the intervention or control group. The intervention group received a local injection of 1 mg/kg ketamine (Elixir Pharmaceutical Company, Iran), while the control group received a placebo. Results: Pain intensity was significantly lower in the ketamine group compared to the control group at multiple time points: baseline, 20 minutes, 60 minutes, 6 hours, and 12 hours post-surgery. At baseline and 20 minutes, pain intensity was reduced by a factor of 3.6 in the ketamine group. After 60 minutes, pain was 3.4 times lower, and at 12 hours, the difference reduced to 0.967, with all comparisons showing statistical significance. Conclusion: Local administration of 1 mg/kg ketamine at the peritonsillar site effectively reduces postoperative pain in pediatric patients undergoing tonsillectomy. This approach provides a promising alternative to traditional pain management methods : Tonsillectomy, ketamine, pain management, postoperative pain relief, pediatric analgesia. 1 10 http://intjmi.com/browse.php?a_code=A-10-1-662&slc_lang=en&sid=1 Maryam Daneshian 10031947532846008242 10031947532846008242 No Assistant Professor of Anesthesiology, Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Mahsa Heydari 10031947532846008243 10031947532846008243 Yes Assistant Professor, Department of Ear, Nose, and Throat, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Maryam Montazami 10031947532846008244 10031947532846008244 No Assistant Professor of Anesthesiology, Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Jamshid Yazdani Charat 10031947532846008245 10031947532846008245 No Epidemiology and Biostatistics Department, School of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran Vajihe Qobadi 10031947532846008246 10031947532846008246 No Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran