PREMEDICATION IN HYPERIRRITABLE CHILDREN USING SUBANAESTHETIC DOSES OF INTRAMUSCULAR KETAMINE.

This study was conducted to highlight the role of intramuscular Ketamine in subanaesthetic doses as a premedicant in highly uncooperative children. Forty children between 1-7 years of age with the highest anxiety level as assessed pre-operatively, were divided into two equal groups. Children in group 'A' received 2 mg/kg and those in group 'B' received 4 mg/kg of intramuscular ketamine, 10 min before induction of anaesthesia. The degree of sedation was observed after 5 min and their response to separation from parents and response to venepuncture was assessed. They were also observed for their post-operative state. It was observed that the children in group 'B' had uniform and predictable sedation (100%) compared to 75% in group 'A'. Response to separation and intravenous access in group 'B' was more favourable (100%) compared to 65% and 75% respectively in group 'A'. Induction and recovery were smooth in both the groups. No incidence of emergence delirium was recorded in any group. It is concluded that preanaesthetic medication and route of administration in infants and young children should be individualised based on their different anxiety levels. Intramuscular ketamine in subanaesthetic dose of 4 mg/kg, is found to be an ideal premedicant in irritable and uncooperative group of paediatric patients.

RCT Entities:   Population Interventions Outcomes