A comparison of two different doses of ketamine with midazolam and midazolam alone as oral preanaesthetic medication on recovery after sevoflurane anaesthesia in children.
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.
Trabold
Benedikt
B
Department of Anesthesiology, University of Regensburg, Regensburg, Germany. benedikt@klinik.uni-regensberg.de
Rzepecki
Angela
A
Sauer
Kay
K
Hobbhahn
Jonny
J
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
D000700:Analgesics; D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D007649:Ketamine; D008874:Midazolam