Comparison of Midazolam and Ketamine as Oral premedicants in pediatric patients

Background: Preanesthetic medication plays an important role in the anesthetic care of children by allaying anxiety, decreasing vagal stimulation and preventing postoperative psychological sequelae. Midazolam and Ketamine are used by oral route as premedicants in pediatric anesthesia. This study was undertaken to compare the two drugs.Methods: Fifty children in the age group of 1 to 7 years posted for elective surgical procedureswere randomly allocated to one of two groups – ‘Group K’ and ‘Group M’. Group K received Ketamine 6 mg.kg p.o. and Group M received Midazolam 0.5 mg.kg p.o.Drug acceptance was noted. Heart rate, arterial pressure, respiratory rate, sedation score, anxiolysis score were notes before drug administration, 15 min and 30 min after drug administration. Parental separation score at 30 min and mask acceptance score were also noted. Sedation scores and anxiolysis scores between the groups were compared by MannWhitney test; Parental separation, drug acceptance and mask tolerance were analysed by Fisher’s exact test. A ‘p value’ of < 0.05 was considered statically significant.Results: Sedation score, anxiolysis score and mask acceptance score were significantly higher in Group-K than in Group-M (p<.05). Hemodynamic parameters, parental separation and drug acceptance were similar in both groups.Conclusion: Ketamine 6 mg.kg p.o. is a better premedicant than Midazolam 0.5 mg.kg p.o. in pediatric patients. Optimum time interval for parental separation is 30 minutes after administration of preanesthetic medication.