{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:34:27Z","timestamp":1786649667639,"version":"build-2736575974"},"reference-count":6,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Effective pain control following tonsillectomy in children remains challenging. Traditionally, opioids such as fentanyl have been used for pain control, but its adverse effect profile makes it a less ideal option for children, particularly those with obstructive sleep apnea. The curent study investigates the perioperative effects of ketamine on postoperative pain and delirium in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this prospective trials, patients 3\u20138 years of age were randomized to receive either fentanyl or ketamine for pain management. Pain was assessed using the face, legs, activity, crying, consolability (FLACC) scale, and emergence delirium was evaluated with the pediatric anesthesia emergence delirium (PAED) scale. Postoperative outcomes, including recovery time and analgesic requirements, were also recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study cohort include 59 pediatric patients. The ketamine group exhibited higher pain scores in the first 15 min post-surgery compared to the fentanyl group. However, pain scores between the two groups were comparable by 30 min. The incidence of emergence delirium was higher with ketamine than fentanul (19.35% versus 3.57%). The groups had similar recovery and post-anesthesia care unit (PACU) times, as well as supplemental analgesia requirements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although ketamine demonstrated delayed pain relief and a higher incidence of emergence delirium, it showed potential as part of a multimodal analgesic approach. The combination of fentanyl and ketamine may optimize pain management in pediatric tonsillectomy, reducing opioid use while minimizing adverse effects. Further studies are needed to refine dosing strategies and assess long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_612_25","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:01:04Z","timestamp":1767337264000},"page":"131-136","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of ketamine and fentanyl in pediatric tonsillectomy: Impact on pain control and emergence delirium"],"prefix":"10.4103","volume":"20","author":[{"given":"Yunus O.","family":"Atalay","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Istanbul Medipol University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse","family":"Ince","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Istanbul Medipol University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif K.","family":"Koc","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Sebinkarahisar State Hospital, Giresun, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hande","family":"Gungor","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Istanbul Medipol University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasar G.","family":"Gul","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Istanbul Medipol University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Toklu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Kocak","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Information, Istanbul Medipol University, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D.","family":"Tobias","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Nationwide Children\u2019s Hospital, Columbus, Ohio, United States of America"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"R1-20260421","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1111\/j.1460-9592.2011.03604.x","article-title":"Ketamine as an adjunct to fentanyl improves postoperative analgesia and hastens discharge in children following tonsillectomy \u2013 A prospective, double-blinded, randomized study","volume":"21","author":"Elshammaa","year":"2011","journal-title":"Pediatr Anesth"},{"key":"R2-20260421","doi-asserted-by":"crossref","first-page":"2997","DOI":"10.2147\/JPR.S281275","article-title":"Opioid-sparing anesthetic technique for pediatric patients undergoing adenoidectomy: A pilot study","volume":"13","author":"Alghamdi","year":"2020","journal-title":"J Pain Res"},{"key":"R3-20260421","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1111\/pan.13662","article-title":"The development of an opioid sparing anesthesia protocol for pediatric ambulatory tonsillectomy and adenotonsillectomy surgery: A quality improvement project","volume":"29","author":"Franz","year":"2019","journal-title":"Pediatr Anesth"},{"key":"R4-20260421","doi-asserted-by":"crossref","first-page":"394","DOI":"10.4103\/1658-354X.121047","article-title":"The effect of ketamine versus fentanyl on the incidence of emergence agitation after sevoflurane anesthesia in pediatric patients undergoing tonsillectomy with or without adenoidectomy","volume":"7","author":"Abdelhalim","year":"2013","journal-title":"Saudi J Anaesth"},{"key":"R5-20260421","doi-asserted-by":"crossref","first-page":"557","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","volume":"17","author":"Dal","year":"2007","journal-title":"Pediatr Anesth"},{"key":"R6-20260421","doi-asserted-by":"crossref","first-page":"440","DOI":"10.4097\/kjae.2010.58.5.440","article-title":"The effect of ketamine on the incidence of emergence agitation in children undergoing tonsillectomy and adenoidectomy under sevoflurane general anesthesia","volume":"58","author":"Lee","year":"2010","journal-title":"Korean J Anesthesiol"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_612_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:56:45Z","timestamp":1786647405000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_612_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":6,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_612_25","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-07-28","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-07","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}