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Efficacy of Addition of Low Dose Oral Ketamine to Oral Midazolam Results in Better Premedication

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Context: When we never induce anesthesia in a struggling adult patient, fearing hypertensive response, we never bother to properly sedate the pediatric patient before bringing the child to operation theatre. Aims: To Compare combination of midazolam and ketamine with midazolam or ketamine alone as oral preanesthetic medication in children undergoing elective surgeries. Settings and Designs: Hospital based comparative study was carried out at Department of Anesthesiology, SVS Medical College, Mahabubnagar Methods: 150 children of ASA Grade I and II in the age group of 2–10 years were included in the study and were randomly divided into three groups of 50 each. Group A received 0.5 mg/kg Midazolam in 5 ml orange syrup, Group B received Ketamine 6 mg/kg while Group C received a combination of oral Midazolam 0.5 mg/kg and oral Ketamine 3 mg/kg in 5 ml orange syrup. Statistical Analysis: The statistical analysis done by Chi-square test. Results: In Group A, 58% children were adequately sedated and 72% children were having an acceptable anxiolysis and\ parental separation scores. In Group B, acceptable sedation, anxiolysis and behavior at parental separation was obtained in 52% children. Group C shows an acceptable sedation in 68% children. Acceptable anxiolysis was observed in 82% of children. 80% children were calm with parental separation. Side effects were mainly seen in Ketamine group with 14% children showing nystagmus and 10% of children had excessive salivation. 8% children in Ketamine Group also developed hallucination. Conclusion: The present study showed that oral premedication with Midazolam 0.5 mg/kg alone produces as good results as the combination of Midazolam 0.5 mg/kg and Ketamine 3 mg/kg in children.

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Context: When we never induce anesthesia in a struggling adult patient, fearing hypertensive response, we never bother to properly sedate the pediatric patient before bringing the child to operation theatre. Aims: To Compare combination of midazolam and ketamine with midazolam or ketamine alone as oral preanesthetic medication in children undergoing elective surgeries. Settings and Designs: Hospital based comparative study was carried out at Department of Anesthesiology, SVS Medical College, Mahabubnagar Methods: 150 children of ASA Grade I and II in the age group of 2–10 years were included in the study and were randomly divided into three groups of 50 each. Group A received 0.5 mg/kg Midazolam in 5 ml orange syrup, Group B received Ketamine 6 mg/kg while Group C received a combination of oral Midazolam 0.5 mg/kg and oral Ketamine 3 mg/kg in 5 ml orange syrup. Statistical Analysis: The statistical analysis done by Chi-square test. Results: In Group A, 58% children were adequately sedated and 72% children were having an acceptable anxiolysis and\ parental separation scores. In Group B, acceptable sedation, anxiolysis and behavior at parental separation was obtained in 52% children. Group C shows an acceptable sedation in 68% children. Acceptable anxiolysis was observed in 82% of children. 80% children were calm with parental separation. Side effects were mainly seen in Ketamine group with 14% children showing nystagmus and 10% of children had excessive salivation. 8% children in Ketamine Group also developed hallucination. Conclusion: The present study showed that oral premedication with Midazolam 0.5 mg/kg alone produces as good results as the combination of Midazolam 0.5 mg/kg and Ketamine 3 mg/kg in children.

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This page is a summary of: Efficacy of Addition of Low Dose Oral Ketamine to Oral Midazolam Results in Better Premedication Than Either Drugs Given Alone in Children, Indian Journal of Anaesthesia and Analgesia, January 2020, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.7120.39.
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