{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:21:37Z","timestamp":1787772097247,"version":"build-2784847793"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective:<\/jats:title>\n This article aimed to assess the efficacy of peritonsillar infiltration with dexmedetomidine-ropivacaine versus tramadol-ropivacaine for pain control and sedation after tonsillectomy in pediatric patients.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n This double-blind clinical trial recruited 99 eligible children (4\u20138 years old) undergoing tonsillectomy and assigned to three block-randomized groups, receiving dexmedetomidine-ropivacaine (group A), tramadol-ropivacaine (group B), or placebo-ropivacaine (group C). The vital signs included blood pressure, heart rate, and SaO\n 2<\/jats:sub>\n before anesthesia induction, during surgery at regular intervals until 24 h after surgery. The duration of surgery and recovery, complications, and analgesic consumption were recorded and pain scores were measured by Children\u2019s Hospital of Eastern Ontario Pain Scale (CHEOPS) and Oucher scales as well as sedation scores by the Wilson sedation scale. Data were analyzed within SPSS 20 at a significance level of 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The lowest pain scores were measured by the CHEOPS scale in the dexmedetomidine-ropivacaine group (\n P<\/jats:italic>\n < 0.05). Statistically significant difference was observed in the CHEOPS pain score between the first two groups at 30 min, 1 h, 2 h, and 4 h after surgery (\n P<\/jats:italic>\n < 0.01). The differences were revealed in the Oucher pain assessments among all groups from the time of recovery to four postoperative hours (\n P<\/jats:italic>\n < 0.05), with the lowest in the dexmedetomidine-ropivacaine group whose sedation score was greater during recovery and 5 min after surgery (\n P<\/jats:italic>\n < 0.05). Subjects in tramadol group had six cases of dizziness and nausea, while no side effects were observed in two other groups (\n P<\/jats:italic>\n < 0.05). Only seven participants receiving dexmedetomidine required acetaminophen, but 29 in the tramadol group and all in the placebo group demanded to receive acetaminophen (\n P<\/jats:italic>\n = 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n The authors concluded that dexmedetomidine as an adjuvant to ropivacaine has better performance in local infiltration for intra- and post-tonsillectomy analgesia and postoperative sedation, without any special side effects (like the placebo group), and that it hence is recommended to be used for local infiltration during tonsillectomy.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/njms.njms_507_21","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T11:00:23Z","timestamp":1710932423000},"page":"40-46","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy of peritonsillar infiltration with dexmedetomidine versus tramadol in comparison to placebo for pain control and sedation after tonsillectomy in pediatric patients: A randomized clinical trial"],"prefix":"10.4103","volume":"15","author":[{"given":"Hesameddin","family":"Modir","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Valiasar Hospital, Arak University of Medical Sciences, Arak, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmail","family":"Moshiri","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Arak University of Medical Sciences, Valiasar Hospital, Arak University of Medical Sciences, Arak, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faezeh","family":"Naghavi","sequence":"additional","affiliation":[{"name":"Students Research Committee, Departments of Anesthesiology and Critical Care, Valiasar Hospital, Arak University of Medical Sciences, Arak, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"R1-20240908","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1016\/j.ijporl.2006.06.002","article-title":"The effect of adenotonsillectomy on children suffering from obstructive sleep apnea syndrome (OSAS):The Negev perspective","volume":"70","author":"Leiberman","year":"2006","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"R2-20240908","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/j.1460-9592.2006.02095.x","article-title":"The efficacy of intravenous or peritonsillar infiltration of ketamine for postoperative pain relief in children following adenotonsillectomy 1","volume":"17","author":"Dal","year":"2007","journal-title":"Pediatr Anesth"},{"key":"R3-20240908","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1097\/00000542-200306000-00030","article-title":"Effects of postoperative, nonsteroidal, antiinflammatory drugs on bleeding risk after tonsillectomy:Meta-analysis of randomized, controlled trials","volume":"98","author":"Marret","year":"2003","journal-title":"Anesthesiology"},{"key":"R4-20240908","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1111\/j.1460-9592.2008.02461.x","article-title":"The preventative analgesic effect of preincisional peritonsillar infiltration of two low doses of ketamine for postoperative pain relief in children following adenotonsillectomy. 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