M Astuto1, N Disma, E Crimi. 1. Department of Anesthesia and Resuscitation, University of Catania, Catania, Italy. astmar@tiscalinet.it
Abstract
BACKGROUND:Oral premedication is common practice in paediatric anaesthesia. The aim of this study was to assess the quality of premedication using oral ketamine, with midazolam. METHODS: Clinical randomized and blind-study on 120 patients, aged between 2 and 6 years, listed for minor surgery. Patients were divided in three groups: first group (group MK1) received midazolam and ketamine at the doses of 0.3 mgxkg-1 and 1 mgxkg-1, respectively; the second (group MK2) received 0.3 mgxkg-1 of midazolam and 2 mgxkg-1 of ketamine; the control group 0.5 mgxkg-1 of midazolam (group M). Success of premedication was assessed by assigning 1-4 points to the quality of anxiolysis and sedation every 5 min after drug administration and then at the moment of separation from parents, entrance to theatre and response to mask induction of general anaesthesia. RESULTS: More patients were successfully premedicated in the MK2 group, statistical significance was observed after 20 min (p<0.05). The MK2 group accepted separation from parents (p<0.05) and face mask for induction of anaesthesia (p<0.05) more willingly. Side effects were observed in 4 MK2 group patients (nausea, headache and diplopia), but all these effects resolved spontaneously. CONCLUSIONS: Two mgxkg-1 of ketamine given orally with midazolam improve anxiolysis and sedation and achieve more success of premedication, better acceptance of parental separation and better acceptance of face mask for induction of anaesthesia.
RCT Entities:
BACKGROUND: Oral premedication is common practice in paediatric anaesthesia. The aim of this study was to assess the quality of premedication using oral ketamine, with midazolam. METHODS: Clinical randomized and blind-study on 120 patients, aged between 2 and 6 years, listed for minor surgery. Patients were divided in three groups: first group (group MK1) received midazolam and ketamine at the doses of 0.3 mgxkg-1 and 1 mgxkg-1, respectively; the second (group MK2) received 0.3 mgxkg-1 of midazolam and 2 mgxkg-1 of ketamine; the control group 0.5 mgxkg-1 of midazolam (group M). Success of premedication was assessed by assigning 1-4 points to the quality of anxiolysis and sedation every 5 min after drug administration and then at the moment of separation from parents, entrance to theatre and response to mask induction of general anaesthesia. RESULTS: More patients were successfully premedicated in the MK2 group, statistical significance was observed after 20 min (p<0.05). The MK2 group accepted separation from parents (p<0.05) and face mask for induction of anaesthesia (p<0.05) more willingly. Side effects were observed in 4 MK2 group patients (nausea, headache and diplopia), but all these effects resolved spontaneously. CONCLUSIONS: Two mgxkg-1 of ketamine given orally with midazolam improve anxiolysis and sedation and achieve more success of premedication, better acceptance of parental separation and better acceptance of face mask for induction of anaesthesia.