English

Abstract

INTRODUCTION: Effective premedication in pediatric patients posted for elective surgeries allays patients' anxiety and reduces risk of post-operative behavioral problems. Oral midazolam and oral ketamine are tried in different doses as pediatric premedicant, but addition of 3mg/kg of oral ketamine with 0.5 mg/kg of oral midazolam resulted in better premedication when compared to oral midazolam 0.5mg/kg or oral ketamine 6mg/kg given alone. MATERIAL AND METHODS: 60 healthy children under 1-8 yrs. age group posted for elective surgeries chosen for this study were randomly divided into two groups of 30 each. Double blinding was done using sealed envelope technique to prevent observer bias. Children with other co-existing illnesses were excluded from the study. Group KM received Ketamine 3 mg/kg and midazolam 0.5 mg/kg + atropine 20 µg/kg (oral route) and Group M received midazolam 0.5 mg/kg and atropine 20 µg/kg (oral route) 30 minutes before proposed induction time. Sedation score, anxiolysis score, parental separation and mask tolerance was assessed in all the patients 30 minutes after administration of the drug. RESULTS: The data collected was analyzed using SPSS statistical software. There was a statistically significant increase in sedation score at 15 and 30 minutes in group KM compared to group M. Parental separation at 30 minutes is peaceful in 30 children (100%) in group KM compared to 24 children (80%) in group M. CONCLUSION: The oral ketamine and midazolam combination produces significantly better anxiolysis, sedation, parental separation and mask tolerance, without hemodynamic alteration, when compared to oral midazolam (0.5mg/kg) given alone.