Pain is a highly unpleasant sensory and emotional experience and postoperative pain control in children is a big challenge for their inability to express and react. In the past two decades, there has been a considerable progress in the understanding of children’s perception of pain and responses to pain and various pharmacological agents and analgesic delivery to avoid under treatment of pain in children. A parallel noteworthy advancement has occurred in the knowledge of anatomy, physiology and pharmacology of regional anesthetic techniques. Some of these techniques are now an integral part of perioperative and procedurerelated pain management in all ages, in part because of a greater concern about postoperative pain management in patients and in part because of technical advances in equipment to perform the blocks. Thus the present prospective comparative study is designed to evaluate the post operative analgesic efficacy of pre-incisional peritonsillar infiltration using tramadol, ketamine alone and combine with bupivacaine, xylocaine & normal saline.