Document Type : Original Article
Authors
Department of Anesthesia and Critical Care, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Objective: In some medical circumstances, pediatric patients may need premedication for
transferring to the operating room. In these situations, using intravenous premedication
is preferred. We assessed the efficacy and safety of intravenous midazolam, intravenous
ketamine, and combination of both to reduce the anxiety and improve behavior in children
undergoing general anesthesia.
Methods: In a double‑blind randomized clinical trial, 90 pediatric patients aged 6 months
to 6 years with American Society of Anesthesiologist grade I or II were enrolled. Before
anesthesia, children were randomly divided into three groups to receive intravenous
midazolam 0.1 mg/kg, or intravenous ketamine 1 mg/kg, or combination of half doses
of both. Behavior types and sedation scores were recorded before premedication, after
premedication, before anesthesia, and after anesthesia in the postanesthesia care unit.
Anesthesia time, recovery duration, blood pressure, and heart rate were also recorded. For
comparing distribution of behavior types and sedation scores among three groups, we used
Kruskal–Wallis test, and for comparing mean and standard deviation of blood pressure and
heart rates, we used analysis of variance.
Findings: After premedication, children’s behavior was significantly better in the combination
group (P < 0.001). After anesthesia, behavior type was same among three groups (P = 0.421).
Sedation scores among three groups were also different after premedication and the
combination group was significantly more sedated than the other two groups (P < 0.001).
Conclusion: Combination of 0.05 mg/kg of intravenous midazolam and 0.5 mg/kg of
intravenous ketamine as premedication produced more deep sedation and more desirable
behavior in children compared with each midazolam 0.1 mg/kg or ketamine 1 mg/kg.
Keywords
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