Comparison of the Preventive Analgesic Effect of Rectal Ketamine and Rectal Acetaminophen after Pediatric Tonsillectomy

Objectives: there is a little data about rectal administration of ketamineas a postoperative analgesic, so we compared the efficacy of rectalketamine with rectal acetaminophen, which is applied routinely foranalgesia after painful surgeries like tonsillectomy.methods: in this single-blinded comparative trial, we enrolled 70children undergoing elective tonsillectomy, and divided them randomlyin two groups. patients received rectal ketamine (2 mg / kg) or rectalacetaminophen (20 mg / kg) at the end of surgery. the children's hospitalof eastern ontario pain scale was used to estimate pain in children.also the vital signs, wilson sedation scale, and side effects in eachgroup were noted and compared for 24 hours.results: the ketamine group had a lower pain score at 15 minutes and60 minutes after surgery in recovery (6.4 ± 0.8, 7.4 ± 1 vs. 7.1 ± 1.2,7.8 ± 1.2 in the acetaminophen group, p < 0.05) and one hour and twohours in the ward (7.2 ± 0.7, 7 ± 0.5 vs. 7.9 ± 1.2, 7.5 ± 1.2 in theacetaminophen group, p < 0.05), with no significant differences till 24hours. dreams and hallucinations were not reported in the ketaminegroup. systolic blood pressure was seen to be higher in the ketaminegroup (104.4 ± 7.9 vs. 99.8 ± 7.7 in the acetaminophen group) andnystagmus was reported only in the ketamine group (14.2%). otherside effects were equivalent in both the groups.conclusions: with low complications, rectal ketamine has analgesiceffects, especially in the first hours after surgery in comparison withacetaminophen, and it can be an alternative analgesic with easy administrationin children after tonsillectomy.