The Study of Using Oral Ketamin as Premedication in Pediatric Surgery

Introduction: Factors like Preparing pediatric patients for anesthesia and surgery, separating them from parents, peculiarity of operation rooms and painful procedures such as injection usually produce anxiety and lack of cooperation in children. Oral premedication with a sedative, anti-anxiety drug which has no major side effects can response to these challenges.

Materials and Methods: In this double-blind experimental study 120 patients ranging from 9 months to 7 years were selected by simple sampling in Taleghani Hospital of Kermanshah. They were allocated randomly in two groups (group A with 60 cases received 6 mg/kg Ketamine dissolved in 0.5cc/kg clear fruit juice and group B with 60 cases received only clear fruit juice 0.5cc/kg). After 30 minutes the five variables of sedation, apprehension and anxiety of separation from parents, mask application and interavenous catheter insertion were observed and documented in check list. Side effects in pre and post- operative periods and recovery time were also observed and analyzed by X² and t test.

Results: 93.4% of group A had sedation score of 3 or more 30 minutes after drinking the drug. Also, 100% of group A were calm when separated from parents and in time of venous cannulation. All of these data showed significant differences between two groups. In group A mean time of sedation initiation was 17.16±2.30 min and at the same time no sedation was observed in group B. Mean recovery time was 16.2±2.3 min in group A and 14.95±2.01 min in group B which showed no significant difference.

Conclusion: Oral premedication by using Ketamine 6mg/kg in clear fruit juice can produce good sedation in pediatric patients after 30 min. This tends to lower apprehension and increase cooperation of patients in mask application and catheter insertion and better parental separation, while the same time side effects are least.