RESUMO
Emergence agitation [EA] is a post-anesthetic problem which interferes with a child's recovery and presents a challenge in terms of assessment and management. In this study, we compared the effects of midazolam and ketamine as premedication in the management of EA in children aged 1-6 years. In this prospective, randomized clinical trial study, 58 children aged 1-6 years who were undergoing general anesthesia for elective surgery in Alzahra Hospital in Isfahan during 2008 until 2009. The patients were randomly assigned to receive 0.1 mg/kg midozolam [28] or 0.5 mg/kg ketamine [29] by IV route in the premedication room. All patients received a standardized anesthetic regimen and isoflurane was used for the maintenance of anesthesia. The incidence and severity of agitation [agitation score], severity of pain [pain score], anesthesia, recovery and extubation durations were recorded postoperatively. The prevalence of agitation in midazolam [21.4%] was lower than ketamine group [34.5%; P<0.05]. In addition, the duration of agitation in ketamine group [21 +/- 16.67 min] was significantly higher than midazolam group [6.83 +/- 6.55 min], [P<0.05]. However, no significant differences were seen in agitation score, pain score, anesthesia, recovery or extubation durations in the two groups [P>0.05]. The study showed that midazolam could reduce the frequency of agitation better than ketamine but both drugs were able to reduce the severity of agitation after short-time surgeries in young children