Comparison of fentanyl and ketamine in children undergoing adenotonsillectomy

Objective: To compare analgesic effect of Fentanyl versus Ketamine in children undergoing adenotonsillectomy.Methodology: This randomized controlled trial was conducted in ENT department of Children Hospital, Lahore from Sep 1, 2018 to Feb 28, 2019. It included 168 cases (84 in each group A and B by lottery method) with age 2-14 years undergoing elective adenotonsillectomy. Patients with heart diseases, congenital anomalies and allergy to paracetamol and opioids were excluded from study. Basic demographic profile was noted. After 8 hours fasting, all patients were pre-medicated with inj. Midazolam 0.05mg/kg. In Group-A, Intravenous fentanyl 1 mu g/kg and in Group-B, Intravenous ketamine 0.2mg/kg was given on induction. Induction was done with propofol 23mg/kg followed by inhalation with sevoflurane in nitrous oxide/oxygen. Post-operative Faces Pain Score was used and pain was measured at 15th minute on arrival to recovery room.Results: Mean age was 7.61 +/- 1.92 years and 7.58 +/- 2.99 years in group A and B, respectively. In group-A, there were 48(57.14%) male and 36(42.86%) females while in group-B, there were 49(58.33%) male and 35(41.67%) female. Mean pain score in group-A was 5.25 +/- 1.76 while in group-B was 5.17 +/- 1.92, with statistically no significant difference in two groups (p>0.05).Conclusion: The mean post operative pain score was statistically same in both groups. The clinician scan safely use any of these drugs for postoperative analgesia in adenotonsillectomy.