Ketamine plus midazolam, a most effective paediatric oral premedicant.
Healthy children, 1.5 to seven years old, were divided into three groups of 20 each. Group 1 received midazolam 0.5 mg.kg-1, Group 2, ketamine 6 mg.kg-1 and Group 3 a mixture of midazolam 0.4 mg.kg-1 + ketamine 4 mg.kg-1. Each dose was mixed with atropine 0.02 mg.kg-1 plus an equal volume of cherry syrup and was given orally 20 to 30 min prior to surgery. A grade of 1 (asleep, difficult to arouse), 2 (asleep, easily aroused), 3 (awake, calm), 4 (awake, anxious, occasional cry), or 5 (crying, agitated), was assigned at the time of parental separation and again when mask induction was begun. A grade of 1-3 was considered successful. For parental separation, the mixture of ketamine+midazolam was 100% successful, ketamine 90% and midazolam 75%. Successful mask induction for the mixture of ketamine+midazolam was 85%, midazolam 65% and ketamine 42%. This study indicates that a mixture of ketamine+midazolam is the most effective.
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000284:Administration, Oral; D000769:Anesthesia, Inhalation; D000778:Anesthetics, Dissociative / Q000008:administration & dosage*; D001007:Anxiety / Q000517:prevention & control; D001143:Arousal / Q000187:drug effects; D001285:Atropine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003448:Crying; D004338:Drug Combinations; D005421:Flavoring Agents; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D007649:Ketamine / Q000008:administration & dosage*; D008397:Masks; D008874:Midazolam / Q000008:administration & dosage*; D014677:Pharmaceutical Vehicles; D011229:Preanesthetic Medication; D011595:Psychomotor Agitation / Q000517:prevention & control; D012890:Sleep / Q000187:drug effects; D014851:Wakefulness / Q000187:drug effects
D000759:Adjuvants, Anesthesia; D000778:Anesthetics, Dissociative; D004338:Drug Combinations; D005421:Flavoring Agents; D006993:Hypnotics and Sedatives; D014677:Pharmaceutical Vehicles; D007649:Ketamine; D001285:Atropine; D008874:Midazolam