Comparison of intranasal ketamine and midazolam premedication in pediatric patients; [Pediyatrik olgularda i̇ntranazal ketamin ile midazolam premedikasyonunun karşilaştirilmasi]
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2004
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Abstract
In our study, effectiveness and safety of intranasal ketamine and midazolam premedication were compared in pediatric patients. After the approval of ethics' committee, 40 ASA I patients, aged between 2-7 years were divided into two groups. 30 min before operation, in group K (ketamine group), ketamine, 5 mg kg-1 and in group M (midazolam group), midazolam, 0.25 mg kg -1 were administered intranasally. Peripheral O2 saturation (SpO2), systolic arterial blood pressure (SAB), diastolic arterial blood pressure (DAB), heart rate (HR) and respiration rate were recorded at 0, 10, 20, and 30th minutes. Sedation levels of patients were evaluated according to the Ramsey Sedation Scale. Separation from the family were evaluated according to a three level scale; (0: Agitate 1: Calm, 2: Sleeping), iv cannulation condition were evaluated according to a three level scale (1: Agitate 2: Pulling his hand away 3: No reaction). Postoperative Aldrete recovery scores and adverse effects were recorded. Demographic data, SpO2 and respiratory rate were similar in both groups. In both groups, there was a significant decrease in SAB, DAB and HR values according to the baseline values (p<0.05). However, the decrease in SAB in midazolam group was more significant than the ketamine group (p<0.05). The sedation scores after 20th min were found to be higher in midazolam group when compared with ketamine group (p=0.02). Midazolam group had higher scores for iv cannulation which was not statistically significant. The scores for separation from the family were similar in two groups. Aldrete scores were higher in group K than group M which is not statistically significant. In group K, diplopia and nystagmus were detected in 4 patients. We concluded that more profound sedation with midazolam and quicker recovery with ketamine in our results may be determining factors in selection of agents for premedication.
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ketamine , midazolam , Aldrete recovery score , American Society of Anesthesiologists classification , anesthetic recovery , arterial pressure , article , breathing rate , child , clinical article , clinical trial , diastolic arterial blood pressure , diastolic blood pressure , diplopia , drug efficacy , drug safety , functional assessment , heart rate , human , intranasal drug administration , nystagmus , oxygen saturation , pediatric anesthesia , premedication , preoperative evaluation , Ramsey Sedation Scale , rating scale , scoring system , sedation , separation anxiety , systolic arterial blood pressure , systolic blood pressure , vein catheterization