Ankylosing Spondylitis (AS) may present significant issues to the anaesthesiologist as potential difficult airway, respiratory and cardiovascular complications, and the concomitant medication therapy to modify symptoms and disease. Awake fibreoptic intubation (AFOI) is a safe option in anticipated difficult airway, as it permits neurological monitoring throughout the attempt at achieving definitive airway. Central neuraxial blockade and peripheral nerve blocks may have good application for these cases. This morbidity renders the patients to greater risk of neurological complications in the peri-surgical period. Neurophysiological monitoring assists the clinician in timely diagnosis and intervention during surgery for cervical spine deformity correction. Addition of anti-tumour necrosis factor-α agents to the medical management has resulted in improved outcomes, however, with concomitant increased potential for wound infections in treated patients. Understanding of potential issues can pave the way for appropriate perioperative management.

Background: Preanaesthetic medication can play an important part in the anaesthetic care of infants and children. It plays a vital role during induction and maintenance of anaesthesia as well as in post-operative period. Methods: Ninety pediatric patients of ASA status I and II operated for routine surgical procedures at GGH, Jamnagar, Gujarat were studied for the comparision of oral midazolam and oral ketamine as a premedication. The paediatric patients were divided into 3 groups, group M oral midazolam, group K oral ketamine and group P placebo (honey) of 30 patients each. Results: All the patients were given general anaesthesia with injection sodium thiopentone 4 to 5 mg/kg and inj. succinylcholine 1.5 mg/kg and maintained with inj. vecuronium and traces of halothane. Paracetamol rectal suppository 10 to 15 mg/kg was inserted before reversal for post-operative analgesia. All patients were reversed with inj. neostigmine 50 μg/kg and inj. glycopyrrolate 8 μg/kg given intravenously slowly. Intraoperative pulse rate, blood pressure, SPO 2 and ECG were recorded. Post operatively apart from vitals sedation score and anxiety score were recorded. The result analysed showed that sedation and anxiolysis was better in ketamine group both during separation from parents and I.V. cannulation. Recovery was smooth in ketamine group whereas recovery in midazolam group was associated with irritability and crying. Conclusions: Oral ketamine is better premedication than oral midazolam in paediatric patients.Cite this article as: Longani S, Mall KP, Raval D. Placebo controlled comparative study of oral midazolam and oral ketamine as a premedication in paediatric age group. Int J Adv Med 2017;4:66-70.