title: A comparison of intranasal ketamine and intranasal midazolam for pediatric premedication.
abstract: OBJECTIVE
  The aim of our study is to compare the efficacy and side-effects of Ketamine and Midazolam administered nasally for the pediatric premedication.
  
  
  METHODS
  We studied 100 American Society of Anesthesiology I and II children aged from 1 to 10 years undergoing various surgical procedures. Totally, 50 children were evaluated for nasal ketamine (using 50 mg/ml vials) at the dose of 5 mg/kg and the other 50 received nasal midazolam 0.2 mg/kg, before induction in operation theater each patient was observed for onset of sedation, degree of sedation, emotional status being recorded with a five point sedation scale, response to venipuncture and acceptance of mask, whether readily, with persuasion or refuse.
  
  
  RESULTS
  The two groups were homogenous. Midazolam showed a statistically significant early onset of sedation (10.76 ± 2.0352 vs. 16.42 ± 2.0696 min). There were no significant differences in venipuncture score, sedation scale at 20 min, acceptance of mask and oxygen saturation throughout the study. Significant tachycardia and 'secretions were observed in the ketamine group intra operatively. Postoperatively emergence (8% vs. 0%) and secretions (28% vs. 4%) were significant in the ketamine group. Nausea and vomiting occurred in l6% versus 10% for midazolam and ketamine group.
  
  
  CONCLUSIONS
  Both midazolam and ketamine nasally are an effective pediatric premedication. Midazolam has an early onset of sedation and is associated with fewer side-effects.
authors.affiliation: Department of Anesthesiology, Shri B. M. Patil Medical College Hospital and Research Centre, BLDE University, Bijapur, Karnataka, India.
authors.forename: P L
authors.initials: PL
authors.lastname: Narendra
authors.affiliation: Department of Anesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.
authors.forename: Ramesh W
authors.initials: RW
authors.lastname: Naphade
authors.affiliation: Department of Anaesthesia and Intensive Care, Queen Elizabeth Hospital, London, SSE 18 4QH, United Kingdom.
authors.forename: Samson
authors.initials: S
authors.lastname: Nallamilli
authors.affiliation: Department of Biostatistics, Shri B. M. Patil Medical College Hospital and Research Centre, BLDE University, Bijapur, Karnataka, India.
authors.forename: Shanawaz
authors.initials: S
authors.lastname: Mohd
keywords: Nasal; pediatric; premedication