Oral ketamine compounds for premedication in children / 中华麻醉学杂志

ABSTRACT

Objective Intramuscular ketamine is often used for premedication in children. Premeditation can also be administered perorally in children. The aim of this study was to evaluate the efficacy of different compounds of ketamine given perorally as premedication in children. Methods Seventy-five ASA Ⅰ- Ⅱ pediatnc patients weighing 10-30 kg undergoing urologic operation were randomly divided into 5 groups of 15 patients each : (1) control group received atropme 0.015 mg ? kg-1 im 30 min before surgery; (2) DA group received intramuscular diazepam 0.2 mg?kg-1 and atropine 0.015 mg?kg-1 30 min before operation; (3) (4) (5) KMA groups received ketamine 3 mg?kg-1 (K3MA) or5mg?kg-1 (K5MA) or 8mg?kg-1 ( K8 MA) + midazolam 0.5 mg?kg-1 + atropine 0.03 mg?kg per os 30 min before operation. SpO2 and heart rate (HR) were monitored and recorded before premedication and at 0, 5, 10, 15, 20, 30 and 40 min after premedication. Peak effect time, duration of operation and emergence time were also recorded. Sedation, anxiolysis and behaviour at separation from parents, during venepuncture and induction were graded and assessed. Results There was no significant difference in duration of operation among the five groups. The peak effect time in the three KMA groups was shorter than that in control and DA group and was shortest in K8MA group. The three KMA groups were significantly better than control and DA group and the K8 MA group was the best in terms of sedation, anxiolysis and analgesia. The incidence of adverse effects like diploplia headache and agitation was higher in K8MA group. Conclusion K5MA group provides satisfactory sedation and analgesia similer to Kg MA group with less side-effects, so is the oral ketamine compound of choice for premedication in children.