Adenotonsillectomy is very common pediatric day-case procedure that is associated with postoperative pain. Preemptive analgesia is based on administration of an analgesic before a painful stimulus is generated, so as to prevent the subsequent rebound mechanism. Significant complications including airway obstruction, protracted vomiting and bleeding can occur after adenotonsillectomy. So, it is important that the patient is awake and able to protect the airway as soon as possible after the surgery. Opioids, due to their associated somnolence, respiratory depression and nausea may contribute to significant postoperative morbidity. Tramadol is an analgesic with mixed-opioid and non-opioid activities. Tramadol offers similar analgesic potential to morphine; however, it has significantly less respiratory depression effects compared to morphine.