A comparative study between midazolam, ketamine and combination of both as a premedication in pediatric surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 6, Issue 2
Abstract
Background: Midazolam andketamine are widely used oral pre anesthetic medication. This study was planned to compare midazolam and ketamine alone with combination of midazolam and ketamine as oral pre-anesthetic medication in children (2-10 Years) with respect to assess the levels of sedation, anxyolysis, behavior at parental separation and side effects. Methods: This prospective randomized study was conducted among childrenadmitted in various departments of Meenakshi Medical College Hospital and Research Institute, Kanchipuram during month of June 2014 to April2015. 150 patients between age 2-10 years, who belongs to ASA grade I and IIwere included. Patients with history of prematurity, developmental delay, increased intracranial pressure and increased intra ocular pressure were excluded. Children were randomized and divided into three groups and group A-midazolam (0.5mg/kg), group B -ketamine (6mg/kg) and group C - midazolam (0.5mg/kg) and ketamine (3mg/kg). The results were assessed in terms of levels of sedation, anxyolysis, behavior at parental separation and side effects. Results: Acceptable sedation score, anxyolysis score and behavior at parental separation score following midazolam use was 58%, 72% and 72%, respectively.Following ketamine use, 52% of children had acceptable sedation score, anxyolysis score and behavior at parental separation score. Combination of midazolam and ketamine use reported acceptable sedation score, nxyolysis score and parental separation score was reported as 68%, 82% and 82%, respectively. There was no significant difference in sedation in the 3 groups (p>0.05). Also, both anxiolysis and behavior at parental separation scores were significantly better in midazolam alone or in the combination group. Conclusion: Even though, the combination did not produce statistically better sedation, anxiolysis or behavior at parental separation than midazolam, the combination did produce distinctly better premedication characteristics than either midazolam or ketamine alone when given through oral route.
Authors and Affiliations
Mithun B, Anand B
A comparative study of haemodynamic and electrolyte changes between 1.5% Glycine and distilled water as irrigation fluid for transurethral resection of prostate surgeries
This prospective comparative study was conducted to study and compare the perioperative haemodynamic and electrolyte changes when 1.5% Glycine and sterile distilled water is used as an irrigation fluid for transurethral...
Anesthetic management of a patient with insulinoma
Insulinomas are an uncommon cause for recurrent hypoglycemia. Surgical resection is the definitive treatment. We present a case of a36-year-old male patient diagnosed with insulinoma and right parathyroid adenoma who had...
A prospective study to compare the effect of ketamine and sodium thiopental in drug resistant major depression
Background: Major depression or major depressive order is characterized by persistent feeling of sadness or lack of interest in any outside stimulus. Electroconvulsive therapy (ECT) is one of the most successful options...
A comparative study of colloid versus crystalloid as preloading infusion for prevention of hypotension in spinal anaesthesia
Background: Subarachnoid block is considered a safe regional anaesthesia technique. This technique is widely used for both elective as well as emergency surgical procedures. It is a good anaesthesia technique for surgeri...
Incidence of complications after prophylactic phenylephrine and placebo in elective urological surgeries
Background: Spinal anesthesia is commonly practiced neuraxial anesthesia for various surgeries including gynecological, obstetrics, urological, orthopedics, etc. The most common impediments to the effective use of neurax...