Comparative evaluation of atomized intranasal midazolam and intranasal ketamine as sedative premedication in children for child-parent separation
Keywords:
atomized intranasal midazolam, intranasal ketamine, sedative premedication, child-parent separationAbstract
Background: In this study we wanted to compare intranasal atomized spray of midazolam 0.5 mg/kg with ketamine 5 mg/kg, as sedative premedicants for a child patient to treat separation anxiety in paediatric surgical procedures with regard to the quality and rate of onset of sedation, sedation score, and behaviour score at the time of separation from parents and during gas induction of anaesthesia. we also wanted to compare any perioperative adverse effects of the premedication like airway obstruction, desaturation, bradycardia, sneezing, vomiting etc., acceptance of nasal spray and any delay in recovery from anaesthesia. Methods: This prospective study was undertaken in 60 paediatric patients aged between 1 and 6 years, belonging to both sexes of ASA grade 1 or 2 undergoing elective surgical procedures under general anaesthesia. The study was conducted at Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu. Group 1 received intranasal ketamine 5 mg/kg and Group 2 received intranasal midazolam 0.5 mg/kg. Patient’s heart rate, SpO2, sedation score, behaviour score and any side effects like nausea, vomiting, airway obstruction etc. were noted at 5 min intervals for a duration of 20 minutes.
Downloads
References
Cote CJ, Lerman J, Todres ID. The Practice of Pediatric Anesthesia. Chap 1. In: The practice of anesthesia for infants and children. 4th edn Saunders Elsevier 2009:1-6.
Chiaretti A, Barone G, Rignate D, et al. Intranasal lidocaine and midazolam for procedural sedation in children. Arch Dis Child 2011:96(2):160-3.
Cravero JP, Kain ZN. Pediatric anesthesia. Chap- 45. In: Barash PG, Culler BF, Stoelting RK, et al. Clinical Anaesthesia. 6th edn. Philadelphia: Lippincott Williams & Wilkins Wolters Kluwer Business 2009:1207-1211.
Kain ZN, Mayes L, Bell C, et al. Premedication in the United States: a status report. Anesth Analg 1997;84(2):427–32.
Yamada T. The potential of the nasal mucosa route for emergency drug administration via a high-pressure needleless injection system. Anesth Prog 2004;51(2):56-61.
Mathison S, Nagilla R, Kompella UB. Nasal route for direct delivery of solutes to the central nervous system: fact or fiction? J Drug Target 1998;5(6):415-41.
Kazemi AP, Kamalipour H, Seddighi M. Comparison of Intranasal midazolam versus ketamine as premedication in 2-5 years old pediatric surgery patients. Pak J Med Sci 2005;21(4):460-4.
Anisha De, Gupta PK, Singh RB. Midazolam as intranasal spray in paediatric surgical patients. International Journal of Basic and Applied Medical Sciences 2013;3(3):208-17.
Ramesh K, Adarsh ES, Uday A, et al. Comparison of the midazolam transnasal atomizer and oral midazolam for sedative premedication in paediatric cases. J Clin Diagn Res 2011;5(5):932-4.
Jahromi SAH, Valami SMH, Adeli N, et al. Comparison of effects of intranasal midazolam versus different doses of intranasal ketamine on reducing preoperative pediatric anxiety: a prospective randomised clinical trial. J Anesth 2012;26(6):878-82.
Louon A, Reddy VG. Nasal midazolam and ketamine for pediatric sedation during computerised tomography. Acta Anesthesiology Scand 1994:38(3):259-261.
Davis PJ, Tome JA, McGowan FX, et al Pre-anesthetic medication with intranasal midazolam for brief pediatric surgical procedures. Effect on recovery and hospital discharge times. Anesthesiology 1995;82(1):2-5.
Lin SM, Liu K, Tsai SK, et al. Rectal ketamine versus intranasal ketamine as premedicant in children. Ma Zui Xue Za Zhi 1990;28(2):177-83.
Pandey RK, Bahetwar SK, Saksena AK, et al. A comparative evaluation of drops versus atomized administration of intranasal ketamine for the procedural sedation of young uncooperative pediatric dental patients: a prospective crossover trial. J Clin Pediatr Dent 2011;36(1):79-84.
Wolfe TR, Braude DA. Intranasal medication delivery for children: a brief review and update. Pediatrics 2010;126(3):532-7.
Widana, I.K., Dewi, G.A.O.C., Suryasa, W. (2020). Ergonomics approach to improve student concentration on learning process of professional ethics. Journal of Advanced Research in Dynamical and Control Systems, 12(7), 429-445.
Widana, I.K., Sumetri, N.W., Sutapa, I.K., Suryasa, W. (2021). Anthropometric measures for better cardiovascular and musculoskeletal health. Computer Applications in Engineering Education, 29(3), 550–561. https://doi.org/10.1002/cae.22202
Published
How to Cite
Issue
Section
Copyright (c) 2022 International journal of health sciences
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.