A Comparative Study Between Intranasal Midazolam and Ketamine as Premedication in Pediatric Patients

ABSTRACT

Introduction: Surgery and anesthesia can be a traumatic experience for a child. Stormy induction of anesthesia in children canlead to an increased incidence of post-operative behavioral problems. Thus, sedative premedication may be used in childrento aid smooth induction of anesthesia. Hence, this study was conducted to compare the preanesthetic sedative effects ofintranasal midazolam and ketamine.Materials and Methods: This study was carried out on 60 ASA Grades I and II pediatric patients aged 2–5 years undergoingemergency or elective surgery lasting for 30 min–2 h. The exclusion criteria were established. Patients were included after writteninformed consent of the parent/guardian. They were randomly divided into two groups Group M and Group K. Pre-operative,intraoperative, and post-operative parameters were observed.Results: Statistically significant tachycardia and increased blood pressure (BP) (both clinically insignificant) were observed inboth the groups (more persistent in the ketamine group). The sedation by both the drugs was adequate in terms of parentalseparation score, acceptance of facemask and response to venipuncture with no statistically significant difference. There werealso no significant side effects (namely, respiratory depression, increased secretions or emergence reaction).Conclusion: Both the drugs midazolam and ketamine provide adequate preanesthetic sedation through intranasal route andare safe to use in pediatric patients without any significant side effects.