ABSTRACT
STUDY OBJECTIVES: To evaluate the effectiveness of ketamine in the prevention of postoperative pain after tonsillectomy. DESIGN: Randomized, prospective, double-blind study. SETTING: University hospital. PATIENTS: 90 ASA physical status I and II patients, aged 5 to 15 years, scheduled for tonsillectomy or adenotonsillectomy. INTERVENTIONS: Patients were divided into three groups. The pain preventive group received intravenous (IV) ketamine 0.5 mg/kg in 2 mL saline before the tonsils were surgically removed, followed by a continuous IV infusion of ketamine at 6 micro/(kg/min). In the ketamine group, 2 mL saline was given before the tonsils were surgically removed; saline infusion (10 mL/h) was continued until bleeding control, and 0.8 mg/kg ketamine was given during bleeding control in 2 mL saline. In the control group, only saline was given. MEASUREMENTS AND MAIN RESULTS: Cardiorespiratory system data, recovery from anesthesia and discharge parameters, tramadol requirement, and complications were recorded. Recovery from anesthesia and discharge parameters were similar among the groups. Total dose of tramadol was lower in the pain preventive group than in the other groups. In the pain preventive group, verbal pain scale scores were lower in the early postoperative period in the fourth and sixth hours (P < 0.05). CONCLUSIONS: Ketamine decreases postoperative analgesic requirements and has analgesic effects when used before surgery in tonsillectomy/adenotonsillectomy.
Subject(s)
Adenoidectomy/adverse effects , Ambulatory Surgical Procedures/methods , Intraoperative Care/methods , Ketamine/therapeutic use , Pain, Postoperative/prevention & control , Tonsillectomy/adverse effects , Adolescent , Analgesics/administration & dosage , Analgesics/adverse effects , Analgesics/therapeutic use , Analgesics, Opioid/administration & dosage , Anesthesia Recovery Period , Child , Child, Preschool , Double-Blind Method , Female , Humans , Infusions, Intravenous/methods , Ketamine/administration & dosage , Ketamine/adverse effects , Male , Pain Measurement/methods , Postoperative Complications/prevention & control , Prospective Studies , Sodium Chloride/administration & dosage , Time Factors , Tramadol/administration & dosage , Treatment OutcomeABSTRACT
BACKGROUND: Clitoromegaly is a frequent congenital malformation, but acquired clitoral enlargement is relatively rare. METHODS: Two acquired clitoromegaly cases treated in Ataturk Training Hospital, Izmir, Turkey are presented. RESULTS: History from both patients revealed clitoromegaly over the last three years. Neither gynecological nor systemic abnormalities were detected in either patient. Karyotype analyses and hormonal tests were normal. Abdominal and gynaecological ultrasound did not show any cystic lesion or other abnormal finding. Computerized tomography scan of the adrenal glands was normal. Clitoroplasty with preservation of neurovascular pedicles was performed for the treatment of clitoromegaly. CONCLUSION: The patients were diagnosed as "idiopathic isolated" clitoromegaly. To the best of our knowledge, there has been no detailed report about idiopathic clitoromegaly in the literature.
