Published in International Journal of Pediatric Otorhinolaryngology 78 (10), 1735-41 (Oct 2014)
Authors: Tong Y, Ding X, Wang X, Ren H, Chen Z, Li Q
OBJECTIVES Peri-operative ketamine peritonsillar infiltration in children can reduce the incidence of postoperative nausea and vomiting (PONV), but its postoperative analgesic time is short. A previous meta-analysis in 2011 was inconclusive due to insufficient data. Consequently, we updated the meta-analysis to verify the role of ketamine peritonsillar infiltration for tonsillectomy in pediatric patients.
METHODS Ten randomized controlled trials with a total of 522 cases were included. Pain intensity was measured by standard modified CHEOPS score.
RESULTS The pain scores of ketamine group at 30min and 60min were significantly lower than placebo group after surgery [weighted mean difference (WMD) -1.20, 95% CI -2.20 to -0.19, P=0.02; WMD -1.71, 95% CI -2.12 to -0.22, P=0.02]. Analgesic requirement in ketamine group were less than placebo group [risk ratio (RR) 0.51, 95% CI 0.26-0.97; P=0.04]. Moreover, the incidence of PONV was lower in ketamine group. (RR 0.73, 95% CI 0.54-0.97; P=0.03). However, there were no differences between these two groups in operation time, anesthesia time, first analgesic time and pain score at 120min.
CONCLUSIONS Compared to placebo, ketamine peritonsillar infiltration can relieve postoperative pain within one hour but not at 120min and reduces analgesic requirement and incidence of PONV. Moreover, there was no difference in the first analgesic time.