Comparative Study of Oral Premedication in Children with Ketamine and Midazolam
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 1
Abstract
Introduction: Pre-operative anxiety (anxiety regarding impending surgical experience) in children is a common phenomenon that has been associated with a number of negative behaviors during the surgical experience (e.g. agitation, crying, spontaneous urination and the need for physical restraint during anaesthetic induction). If children are less anxious during the peri-operative period, not only will they often exhibit less behavioral disturbances post-operatively, but they may face subsequent medical care more easily. The aim of the study was to compare the efficacy and safety of orally administered midazolam and ketamine for premedication. Material and Methods: Sixty children of either gender participated in the study. All of them belonged to ASA physical status I as outlined by the American Society of Anaesthesiologists (ASA). They are randomly divided into two groups, 30 children in group A and 30 children in group B. Group A patients received 0.5mg/kg of oral midazolam as a premedicant 45 minutes before induction. Group B Patients received 6mgs/kg of oral ketamine as a premedicant 45 minutes before induction. Time of onset of sedation and sedation score at 30 minutes were noted. Anxiety score at separation from parents, room air saturation, response to pre-oxygenation, side effects, if any, preoperatively and postoperatively were also noted. Results: The study groups were similar with respect to age, weight, parent-child separation times and duration of surgery. In our study, the mean time of onset of sedation was lower with ketamine group (19.48 minutes) as compared to the midazolam group (25.63). The sedation score at 30 minutes and anxiety score at separation from parents were also satisfactory. The study found that ketamine was well accepted by all children. In our study, the mean sedation score at 30 minutes was 1.9 with ketamine group and 3.03 in midazolam group. Similarly the mean anxiety score at separation was 1.8 with ketamine group and 2.53 in midazolam group. All patients allowed calm separation from parents. Conclusion: It is concluded that pre-medication with ketamine at a dose of 6 mgs/kg orally provides better sedation and anxiolysis in children with minimal side effects than oral pre-medication with midazolam at the dose of 0.5 mg/kg.
Authors and Affiliations
Geetanjali S Masamaddi, V Poornima
Keywords
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