Comparison of efficacy of oral ketamine and oral midazolam as premedicant in paediatric patients

Abstract

Background: The usual goals of premedication are to reduce anxiety and to ease separation from parents and premedication for each child must be individualized. The aim of study was to compare the efficacy and safety of oral ketamine and oral midazolam as premedicant in pediatric patients aged 1 to 10yrs. Methods: The study was carried out in Medical college hospital Bijapur from November 2013 to October 2014. After obtaining institutional ethical committee clearance informed consent was taken from parents. Patients who were scheduled for elective surgeries aged between1 and 10 years were divided in two groups of 30 each, receiving Ketamine 50mg/ml in a dose of 6mg/kg and Midazolam 1mg/ml vial in a dose of 0.5mg/kg. We observed the degree of sedation using sedation score, anxiolysis using anxiety score, the behavior of the child at induction, reaction of the child to intravenous cannulation and any adverse effects. Results: Both the treatment groups were similar in respect of age, sex, weight, behaviour. After the administration of the medications, pulse, systolic or diastolic blood pressures or arterial oxygen saturation were not statistically different in the two patient groups. However, both venepuncture scores and acceptance of facemask was seen to be statistically better (p < 0.001) with ketamine as compared to midazolam. Conclusion: Oral administration of sedatives has become the standard of care at many institutions and our results show that premedication with 6mg/kg of oral ketamine is better than 0.5mg/kg of oral midazolam in achieving better acceptability, sedation and anxiolysis.

Keywords

• Anxiety Ketamine
• Midazolam
• Premedication
• Sedation