Oral Midazolam Alone or in Combination with Ketamine as Oral Premedication in Pediatric Ophthalmologic Surgeries
Background: Administrating premedication for children undergoing outpatient ophthalmologic procedures to reduce costs and increase efficiency is very important. The mostly used drugs for premedication are midazolam and ketamine. In this study, we compared the effectiveness of combined oral midazolam...
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Isfahan University of Medical Sciences
2014-01-01
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| Series: | مجله دانشکده پزشکی اصفهان |
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| Online Access: | http://jims.mui.ac.ir/index.php/jims/article/view/2228 |
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| author | Parvin Sajedi Omid Aghadavoudi Fereshteh Salimi-Jazi |
| author_facet | Parvin Sajedi Omid Aghadavoudi Fereshteh Salimi-Jazi |
| author_sort | Parvin Sajedi |
| collection | DOAJ |
| description | Background: Administrating premedication for children undergoing outpatient ophthalmologic procedures to reduce costs and increase efficiency is very important. The mostly used drugs for premedication are midazolam and ketamine. In this study, we compared the effectiveness of combined oral midazolam and ketamine with oral midazolam alone in outpatient pediatric ophthalmologic surgeries.
Methods: In this double-blinded randomized clinical trial study, 136 children aged 6 months to 6 years undergoing outpatient ophthalmologic procedures with class I or II in American Society of Anesthesiologists (ASA) scale and without systemic disease were enrolled. Children were randomly divided in two groups. Thirty minutes before operation, group 1 received oral midazolam 0.5 mg/kg and group 2 received oral midazolam 0.25 mg/kg with ketamine 2.5 mg/kg. Medications were mixed with strawberry-flavored juice with volume of up to 0.5 ml/kg. In both groups, children’s basic behavior, acceptance of premedication, anxiolysis (30 minutes after premedication), sedation at 10, 20, and 30 minutes after premedication, parental separation behavior (30 minutes after premedication), children’s puncture behavior, number of attempts for venipuncture, puncture duration, post-anesthetic arousal stage at the end of anesthesia and recovery duration were be compared. Any complication like nausea and vomiting were also recorded.
Findings: There were significant differences between two groups in sedation score and children's puncture behavior score. There were no significant differences between the two groups regarding the children’s behavior type, acceptance, anxiolysis, parental separation, and arousal stage behavior scores. Numbers of attempts for venipuncture, puncture duration and recovery variables were similar in the two groups. Nausea was seen in one child in both groups. 2 children in combination group vomited.
Conclusion: Oral premedication with low dose combination of midazolam and ketamine makes earlier and more effective sedation and better puncture behavior than oral midazolam alone. |
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| format | Article |
| id | doaj.art-f1e91d16f12249fea6c4ca3fe2a9eec9 |
| institution | Directory Open Access Journal |
| issn | 1027-7595 1735-854X |
| language | fas |
| last_indexed | 2024-03-12T09:03:13Z |
| publishDate | 2014-01-01 |
| publisher | Isfahan University of Medical Sciences |
| record_format | Article |
| series | مجله دانشکده پزشکی اصفهان |
| spelling | doaj.art-f1e91d16f12249fea6c4ca3fe2a9eec92023-09-02T15:32:31ZfasIsfahan University of Medical Sciencesمجله دانشکده پزشکی اصفهان1027-75951735-854X2014-01-0131262190119091467Oral Midazolam Alone or in Combination with Ketamine as Oral Premedication in Pediatric Ophthalmologic SurgeriesParvin Sajedi0Omid Aghadavoudi1Fereshteh Salimi-Jazi2Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, IranAssociate Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, IranStudent of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, IranBackground: Administrating premedication for children undergoing outpatient ophthalmologic procedures to reduce costs and increase efficiency is very important. The mostly used drugs for premedication are midazolam and ketamine. In this study, we compared the effectiveness of combined oral midazolam and ketamine with oral midazolam alone in outpatient pediatric ophthalmologic surgeries. Methods: In this double-blinded randomized clinical trial study, 136 children aged 6 months to 6 years undergoing outpatient ophthalmologic procedures with class I or II in American Society of Anesthesiologists (ASA) scale and without systemic disease were enrolled. Children were randomly divided in two groups. Thirty minutes before operation, group 1 received oral midazolam 0.5 mg/kg and group 2 received oral midazolam 0.25 mg/kg with ketamine 2.5 mg/kg. Medications were mixed with strawberry-flavored juice with volume of up to 0.5 ml/kg. In both groups, children’s basic behavior, acceptance of premedication, anxiolysis (30 minutes after premedication), sedation at 10, 20, and 30 minutes after premedication, parental separation behavior (30 minutes after premedication), children’s puncture behavior, number of attempts for venipuncture, puncture duration, post-anesthetic arousal stage at the end of anesthesia and recovery duration were be compared. Any complication like nausea and vomiting were also recorded. Findings: There were significant differences between two groups in sedation score and children's puncture behavior score. There were no significant differences between the two groups regarding the children’s behavior type, acceptance, anxiolysis, parental separation, and arousal stage behavior scores. Numbers of attempts for venipuncture, puncture duration and recovery variables were similar in the two groups. Nausea was seen in one child in both groups. 2 children in combination group vomited. Conclusion: Oral premedication with low dose combination of midazolam and ketamine makes earlier and more effective sedation and better puncture behavior than oral midazolam alone.http://jims.mui.ac.ir/index.php/jims/article/view/2228MidazolamKetamineOutpatient pediatric ophthalmologic surgeryPremedication |
| spellingShingle | Parvin Sajedi Omid Aghadavoudi Fereshteh Salimi-Jazi Oral Midazolam Alone or in Combination with Ketamine as Oral Premedication in Pediatric Ophthalmologic Surgeries مجله دانشکده پزشکی اصفهان Midazolam Ketamine Outpatient pediatric ophthalmologic surgery Premedication |
| title | Oral Midazolam Alone or in Combination with Ketamine as Oral Premedication in Pediatric Ophthalmologic Surgeries |
| title_full | Oral Midazolam Alone or in Combination with Ketamine as Oral Premedication in Pediatric Ophthalmologic Surgeries |
| title_fullStr | Oral Midazolam Alone or in Combination with Ketamine as Oral Premedication in Pediatric Ophthalmologic Surgeries |
| title_full_unstemmed | Oral Midazolam Alone or in Combination with Ketamine as Oral Premedication in Pediatric Ophthalmologic Surgeries |
| title_short | Oral Midazolam Alone or in Combination with Ketamine as Oral Premedication in Pediatric Ophthalmologic Surgeries |
| title_sort | oral midazolam alone or in combination with ketamine as oral premedication in pediatric ophthalmologic surgeries |
| topic | Midazolam Ketamine Outpatient pediatric ophthalmologic surgery Premedication |
| url | http://jims.mui.ac.ir/index.php/jims/article/view/2228 |
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