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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2002 July-August;68(7-8):593-8

language: English

Two doses of oral ketamine, given with midazolam, for premedication in children

Astuto M. 1, Disma N. 1, Crimi E. 2

1 Department of Anesthesia and Resuscitation, University of Catania, Catania
2 Department of Anesthesia and Resuscitation, “A. Avogadro” University of Eastern Piedmont, Novara, Novara


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 mg·kg-1 and 1 mg·kg-1, respec­tive­ly; the sec­ond (­group MK2) ­received 0.3 mg·kg-1 of mid­az­o­lam and 2 mg·kg-1 of ket­a­mine; the con­trol ­group 0.5 mg·kg-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 mg·kg-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.

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