Abstract：Objective To study the efficacy and safety of dexmedetomidine combined with ketamine before pediatric tonsillectomy. Methods Ninety children of ASA grade Ⅰ~Ⅱ, aged 2 to 6 and weighing 13-25 kg underwent tonsillectomy in our hospital between January 2019 to December 2020.These patients were randomly assigned to three groups with 30 cases in each. Before operation, dexmedetomidine, ketamine, and dexmedetomidine combined with ketamine were instilled respectively through the nose. After 45 minutes, they were transferred to the operating room for anesthesia and enucleation before they returned to their wards after operation. The preoperative heart rate, mean arterial pressure, blood oxygen saturation, sedation score, and postoperative recovery time, extubation time, pain score, agitation score, and adverse reactions were compared between the three groups. Results Hemodynamic results showed that the heart rate of the D+K group decreased significantly at the 45th minute, and the difference was statistically significant (P<0.05).The sedation status score of the D+K group was significantly lower, the sedation effect was better than that of the D and K groups, and the difference was statistically significant (P<0.05). A comparison of postoperative conditions showed that children in the D+K group had a shorter wake-up time and lower scores of postoperative restlessness, and the difference was statistically significant (P<0.05). Although the incidence of adverse reactions was not significantly different between the three groups, the number of adverse reactions in the D+K group was significantly smaller than in the other two groups. Conclusions The sedative effect of dexmedetomidine combined with ketamine before pediatric tonsillectomy is better than that of the two used alone, for restlessness can be effectively prevented during recovery. Therefore, it is a safe and efficient sedation method.
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