References
Postoperative pain, postoperative pain, pain
ADVERSE EFFECTS, INFILTRATION


 Title:
Postoperative opioid requirements were assessed only in the PACU. Postoperative pain is your primary outcome. Please rephrase your title. Methods:
Difficult airways should be considered as an  exclusion criteria because you had assessed VAS during swallowing.Please precisely include which ketamine concentration was used.

Baseline characteristics should be comparable between the two groups. Please verify your data (age, performed surgery).You have many VAS assessments exceeding 3/10. What was your rescue analgesia?


The choice of ketamine dosage should be discussed.

"However, the use of ropivacaine was not associated with an analgesic effect.

  
VAS was considered as a limitation while it is a validated tool.
 Conclusion:
Please put “to reduce” instead of “to reducing”.

In this study, researchers investigated the effects of local ketamine wound infiltration versus saline placebo on postoperative pain and opioid consumption in patients undergoing thyroid surgery. After randomizing 64 patients to receive either ketamine or saline infiltration, the researchers found that the ketamine group had lower VAS pain scores during the PACU stay for static pain at rest and dynamic pain on swallowing. The ketamine group consumed significantly less morphine in the PACU than the saline group. No adverse effects were reported. The authors concluded that local ketamine can reduce postoperative opioid use without increasing side effects. This study is well-designed and addresses an important clinical question. We recommend you to :
Provide more details regarding the randomization process: Was a computer random number generator used? Were block randomization or stratification techniques used?Presenting VAS scores graphically could better visualize trends.Is the work clearly and accurately presented and does it cite the current literature?YesIf applicable, is the statistical analysis and its interpretation appropriate?YesAre all the source data underlying the results available to ensure full reproducibility?YesIs the study design appropriate and is the work technically sound?YesAre the conclusions drawn adequately supported by the results?YesAre sufficient details of methods and analysis provided to allow replication by others?YesReviewer Expertise:Regional anesthesia, Anesthesiology, critical care, cardiac anesthesia, artificial intelligenceWe confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

 In this study, researchers investigated the effects of local ketamine wound infiltration versus saline placebo on postoperative pain and opioid consumption in patients undergoing thyroid surgery. After randomizing 64 patients to receive either ketamine or saline infiltration, the researchers found that the ketamine group had lower VAS pain scores during the PACU stay for static pain at rest and dynamic pain on swallowing. The ketamine group consumed significantly less morphine in the PACU than the saline group. No adverse effects were reported. The authors concluded that local ketamine can reduce postoperative opioid use without increasing side effects. This study is well-designed and addresses an important clinical question. We recommend you to : Provide more details regarding the randomization process: Was a computer random number generator used? Were block randomization or stratification techniques used?

 Presenting VAS scores graphically could better visualize trends.

