CLINICAL EVALUATION OF ORAL KETAMINE AND ORAL MIDAZOLAM FOR PREMEDICATION IN PAEDIATRIC SURGICAL OUTPATIENTS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 30
Abstract
BACKGROUND Forty children of ASA grade I, aged 1 to 8 years, both males and females undergoing elective surgery under general anaesthesia and regional anaesthesia for procedures such as herniotomy and circumcision were included in the study. MATERIALSAND METHODS Children were allocated randomly into 2 groups. In order to get statistically significant results, a sample size of 20 was allotted to each groups. Group 1 children in this group received oral midazolam 0.5 mg/kg as premedication and group 2 children received oral ketamine 5 mg/kg as premedication. Parenteral formulation of both the drugs was given to the children after mixing with honey. All children were observed and scores allotted by the investigator. Child’s emotional reaction and sedation status were noted on arrival in operation theatre on insertion of IV cannula and on acceptance of facemask. The children were separated from their parents 30 minutes after ingestion of the drug. Any side effect after ingestion of the drug until 4 hours in the postoperative period was looked for. Time of recovery from anaesthesia was noted. It was observed that both the drugs were well accepted by the children. RESULTS Sedation and anxiolysis was better in ketamine group during separation from parents at IV cannulation and facemask application. Both oral midazolam and oral ketamine are excellent agents for premedication in paediatric outpatient surgeries. Considering sedation and emotional scores during arrival in OT, IV cannulation and facemask application, oral ketamine is superior to oral midazolam. No significant adverse effects were found in both the groups. In the recovery room, the 2 groups did not differ significantly with respect to side effects like nausea, vomiting, emergence phenomenon and need for airway support. No haemodynamic instability was recorded. The time of discharge was not delayed in both the groups. CONCLUSION Considering sedation and emotional scores during arrival in OT, IV cannulation and facemask application, oral ketamine is superior to oral midazolam.
Authors and Affiliations
Krishnankutty Saradas Asha, Morris Judith Linnette
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