Comparative study of oral midazolam and oral ketamine as premedication in children

To compare the effect of oral Midazolam and oral Ketamine on sedation and anxiety as premedication in children.

This is a randomized, controlled, prospective study conducted in 60 children undergoing surgery of more than 30 minutes duration.

60 children were divided in two groups. Group M received oral Midazolam 0.5 mg/kg and Group K received oral Ketamine 5 mg/kg as pre medication preoperatively 30 minutes before induction of anaesthesia. Standard general anaesthesia technique was used. Time of onset of sedation, anxiety level at the time of separation from parents and at the time of application of facemask was noted. Any side effect after ingestion of the drug until 6 hours in the post-operative period was looked for. Time of recovery from anaesthesia was noted.

It was observed that both the drugs were well accepted by the children. Sedation and anxiolysis was better in Ketamine group both during separation from parents and during facemask application. Recovery time in both groups was less than 20 minutes. Recovery is smooth in Ketamine group whereas recovery is associated with irritability and crying in Midazolam group. There were minimal side effects in both the groups. This study concludes that oral premedication with 5 mg/kg Ketamine is better than 0.5 mg/kg Midazolam.

Preoperative Ketamine 5mg. kg⁻¹ is a better premedicant than Midazolam 0.5 mg.kg⁻¹ in pediatric patients. Optimum time interval for excellent anxiolysis and sedation from administration of oral premedication to parental separation is 30 minutes in both groups.