Paediatric premedication: The assessment of psychomotor function and sedation with oral midazolam and ketamine

Abstract

Objective: Premedication in children should aim to relieve anxiety and facilitate the induction of anaesthesia. This study was designed to assess the effects of midazolam and ketamine on preoperative psychomotor functions and sedation of children when given orally.

Methods: Twenty-six patients aged 3-6 years were included in the study. The day before surgery, children were familiarised with a postbox toy used for psychomotor performance assessment and the completion times were recorded. Forty-five minutes before surgery children were allocated into two groups (n=13). Group 1 received midazolam 0.5 mg/kg and group 2 received ketamine 5 mg/kg orally. In all the patients, before premedication, at 10“1, 20™, 30^, 40*h minutes of premedication, during separation from parents, arrival at the operating room and IV cannulation, sedation scores and oxygen saturations were recorded. At the 45^ minute of premedication, the postbox tests were again performed. Side effects during induction and recovery were recorded.

Results: Both in groups 1 and 2, the postbox test completion times and sedation scores increased significantly after premedication. But 15% of children in group 1 and 46% of children in group 2 were afraid of IV cannulation. One had hallusinations in group 2.

Conclusion: Midazolam is superior to ketamine for paediatric oral premedication.

Keywords

• Anesthetics,intravenous; midazolam Anesthetics,intravenous; ketamine Premedication; oral

References

1. Jones RDM, Visram AR, Korn berg JP, Irwin MO, Gunavardene WMS. Premedication with oral midazolam in children. An assessment of psychomotor Function, anxlolysis, sedation and pharmacokinetics. Anaesth Intens Care 1994;22:539-544.