The effect of topical ketamine injection at the site of tonsillectomy in reducing post-tonsillectomy pain in people under 18 years of age in Booalisina hospital from 2023 to 2024

The effect of topical ketamine injection at the site of tonsillectomy in reducing post-tonsillectomy pain in people under 18 years of age in Booalisina hospital from 2023 to 2024

Clinical trial, with parallel groups, randomized, double-blind, phase 2-3 on 60 patients, Random allocation software will be used for randomization.

The total sample in each group is 30 people, which will be performed on patients under 18 years of age who are candidates for tonsillectomy, hospitalized in Bo Ali Sina Hospital, Sari during the years 2023 to 2024. /kg of ketamine locally and the second group is considered as a control group that does not receive any medicine.In case of pain control with topical ketamine and the need for painkillers Intravenous acetaminophen is used at a dose of 12 mg/kg every 4 hours with a maximum dose of 75 mg within 24 hours. Post-operative pain (during recovery, 6 and 12 hours after the operation) using The eye analog criterion is asked to the patient by a trained nurse during recovery, hospitalization and under patient observation in the hospital.

A person's willingness to participate in obtaining informed consent. Chronic tonsillitis characterized by 7 or more episodes of sore throat per year for two consecutive years or 3 or more episodes of sore throat per year for three consecutive years.Occurrence of obstructive symptoms related to tonsil hypertrophy.Patients of both sexes under 18 years of age.

The first group is the intervention group, which receives 1mg/kg of ketamine topically.The control group does not receive medication and the patient's pain is treated with intravenous acetaminophen at a dose of 12 mg/kg every 4 hours with a maximum dose of 75 mg within 24 hours after surgery

Postoperative pain measurement time; the amount of pain after the operation.

To control the intervening variables and also to balance the groups in terms of number, a random block method was used based on the order of patients' entry, that is, from the first four patients, the data of 4 patients were allocated to two groups using random allocate software. Then this allocation of four continued until the samples were completed based on the sample size.

After selecting the samples, none of the sampled people will know about randomization and the process of allocation to groups. Patients are included in the study in the order of table numbers. In the intervention group, at the beginning of the surgery, ketamine at a dose of 1mg/kg will be injected locally in the tonsillectomy area for all patients by the attending physician in the operating room. And the control group does not receive medicine. In the case of blinding, the patient and the nurse responsible for evaluating the pain score do not know whether the medicine has been injected into the patient or not. The student is an observer in the operating room.