title: A comparison of two different doses of ketamine with midazolam and midazolam alone as oral preanaesthetic medication on recovery after sevoflurane anaesthesia in children.
abstract: BACKGROUND
  This investigation prospectively evaluated the effect of oral premedication of two different doses of ketamine with midazolam and midazolam alone on the recovery of children after sevoflurane anaesthesia.
  
  
  METHODS
  In a randomized, double-blind study, 79 children (aged 1-8 years, ASA physical status I or II) were assigned to receive one of three premedications in a volume of 0.5 ml x kg(-1): group 1 received midazolam 0.5 mg x kg(-1) (MD); group 2 received midazolam 0.5 mg x kg(-1) with ketamine 1.8 mg x kg(-1) (MK-1); and group 3 received midazolam 0.5 mg x kg(-1) with ketamine 3 mg x kg(-1) (MK-2). The reactions of the children during administration were noted. Anaesthesia was induced by facemask with incremental sevoflurane administration. All children received alfentanil (15 micro g x kg(-1)). Tracheal intubation was facilitated by mivacurium (0.2 mg x kg(-1)). Anaesthesia was maintained with sevoflurane and an additional dose of alfentanil, if necessary. During recovery, the time interval between discontinuation of anaesthesia and arousal (spontaneous ventilation, extubation) were recorded.
  
  
  RESULTS
  Emergence (spontaneous ventilation, extubation) and recovery times (discharge, Aldrete score=9) did not differ significantly between groups (P=0.24, P=0.59 and P=0.145, respectively).
  
  
  CONCLUSIONS
  The combination of midazolam and ketamine as oral preanaesthetic medication did not significantly affect the recovery time of children after sevoflurane anaesthesia.
authors.affiliation: Department of Anesthesiology, University of Regensburg, Regensburg, Germany. benedikt@klinik.uni-regensberg.de
authors.forename: Benedikt
authors.initials: B
authors.lastname: Trabold
authors.forename: Angela
authors.initials: A
authors.lastname: Rzepecki
authors.forename: Kay
authors.initials: K
authors.lastname: Sauer
authors.forename: Jonny
authors.initials: J
authors.lastname: Hobbhahn
mesh_terms: D000284:Administration, Oral; D000700:Analgesics / Q000494:pharmacology*; D000762:Anesthesia Recovery Period; D019162:Anesthetics, Combined / Q000494:pharmacology*; D018685:Anesthetics, Inhalation / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006801:Humans; D007223:Infant; D007649:Ketamine / Q000494:pharmacology*; D008738:Methyl Ethers / Q000627:therapeutic use*; D008874:Midazolam / Q000494:pharmacology*; D011229:Preanesthetic Medication; D011446:Prospective Studies; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D000700:Analgesics; D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D007649:Ketamine; D008874:Midazolam