THE STUDY OF ANESTHETIC EFFECT USING KETAMINE, MIDAZOLAM, GIYCOPYRROLATE IN THE OPERATION OF PEDIATRIC PATIENTS

ABSTRACT

Ketamine hydrochloride is a unique dissociative anesthetic agent that has been used in children for more than 20 years. Ketamine is devoid of sedation and hypnotic properties but has profound analgesic and amnesic characteristics even in low doses. It is recommended to use with benzodiazepines for the alleviation of ketamine-induced emergence reaction and with anticholinergic agent for the antisialogogue affect. We used the intramuscular ketamine, midazolam, and glycopyrrolate in thirty pediatric patients who were uncontrolled by conventional behaviour management in the OPD of Chungbuk National University Hospital Oral & Maxillofacial Surgery and Emergency Room. The results were as follows 1. 20 males and 10 females were involved and the average age was 3 years(range, 19 months to 6 years). 2. The anesthetic technique was used for the following reasons 10 for the I & D of submandibular abscess, 2 for the post operative wound care of cleft lip, and 4 for the other causes. 3. Average onset time of anesthesia was 5.1 minutes(range, 2 to 10 minutes) and average working time was 26 minutes(range, 12 to 50 minutes). 4. 24(80%) of 30 children were rated as 'Cooperative of sleeping' within an average 4.8, and the other children(20%) were rated as 'Intermittent crying or fighting'. 5. Emesis occurred during the recovery period in 2 children, but there was no airway compromise or aspiration. Other side effects were a transient rash(10%), and random movement(7%). 6. The recovery room behavior was quite and uneventful in 23(77%) children and mild agitation in 7(23%) ones.