Oral ketamine

Rowbottam, S.J.; Stewart, K.G.; and, D.A. Sudhaman; Aitken, A.W.

doi:10.1111/j.1365-2044.1991.tb09936.x

Cited by 6 publications

(8 citation statements)

References 2 publications

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“…The main aims of preanaesthetic medication in children are to reduce anxiety associated with the unfamiliar environment, facilitate the separation of the child from their parent (if required) and allow smooth induction of anaesthesia. Both oral midazolam and oral ketamine fulfill many of these characteristics and are useful for preanaesthetic medication in children [2][3][4][5] . Oral midazolam premedication produces good or excellent results in only 60% to 80% of cases while oral ketamine when used alone as premedication in a dose of 6 mg/kg was found to have undesirable effects, such as excessive salivation, hallucinations and dysphoria 6 .…”

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confidence: 99%

Oral Ketamine or Midazolam or Low Dose Combination for Premedication in Children

Darlong

Shende

Subramanyam

et al. 2004

Anaesth Intensive Care

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This randomized controlled trial was designed to evaluate whether the combination of low dose oral midazolam (0.25 mg/kg) and low dose oral ketamine (3 mg/kg) provides better premedication than oral midazolam (0.5 mg/kg) or oral ketamine (6 mg/kg). Seventy-eight children of ASA physical status I or II scheduled for elective ophthalmic surgery were randomly divided into three groups and given premedication in the holding area 30 minutes before surgery. Two subjects from each group vomited the medication and were excluded, leaving 72 subjects for further analysis. The onset of sedation was earlier in the combination group than the other two groups. At 10 minutes after premedication 12.5% in the combination group had an acceptable sedation score compared with none in the other two groups. After 20 minutes 54% in the combination group had an acceptable sedation score, 21% in the midazolam group and 16% in the ketamine group (P<0.05). There were no significant differences in the parental separation score, response to induction and emergence score. The mean time for best parental separation score was significantly less in the combination group (19±8 min) than either the midazolam (28±7) or ketamine (29±7 min) groups (P<0.05). Recovery was earlier in the combination group, as the time required to reach a modified Aldrete score of 10 was significantly less in the combination group (22±5 min) than in the oral midazolam (36±11 min) or ketamine (38±8 min) groups. The incidence of excessive salivation was significantly higher in the ketamine alone group (P<0.05). In conclusion, the combination of oral ketamine (3 mg/kg) and midazolam (0.25 mg/kg) has minimal side effects and gives a faster onset and more rapid recovery than ketamine 6 mg/kg or midazolam 0.5 mg/kg for premedication in children.

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mentioning

confidence: 99%

Oral Ketamine or Midazolam or Low Dose Combination for Premedication in Children

Darlong

Shende

Subramanyam

et al. 2004

Anaesth Intensive Care

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“…In the present study, confusion, bouts of crying, and loss of contact in four out of 59 children 10–20 min after ingestion of ketamine distressed both mothers and nurses. Hallucinatory experiences, bad dreams, confusions or psychotic reactions have been reported before anaesthesia after high‐dose oral ketamine (10 mg/kg) in approximately 10% of cases ( 4, 14, 15), after medium‐dose (5–6.0 mg/kg) in 5–7% ( 4, 16); and none after low‐dose (<3 mg/kg) ( 7, 17). On the other hand, medium‐dose series comprising 129 patients ( 6, 7, 18–20), are reported without any psychotic reactions.…”

Section: Discussionmentioning

confidence: 99%

“…In a limited number of patients (n=15) the incidence of nausea was not increased and no patient had unusual behaviour at home ( 3). A dose of 3.0 mg/kg did not reliably provide sedation ( 3, 4, 7). In two studies oral ketamine relieved venepuncture pain ( 3, 4).…”

mentioning

confidence: 99%

“…A dose of 3.0 mg/kg did not reliably provide sedation ( 3, 4, 7). In two studies oral ketamine relieved venepuncture pain ( 3, 4). Because of its bad taste it has to be flavoured, for example by a cola drink ( 3).…”

mentioning

confidence: 99%

“…B ECAUSE of its sedative effect, ketamine has been successfully used for oral premedication in doses of 6.0 mg/kg ( 1–6). This dose of ketamine did not prolong the recovery time.…”

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confidence: 99%

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Efficacy and safety of premedication with oral ketamine for day‐case adenoidectomy compared with rectal diazepam/diclofenac and EMLA^®

Filatov¹,

Baer²,

Rorarius³

et al. 2000

Acta Anaesthesiol Scand

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Oral premedication for paediatric ambulatory anaesthesia: a comparison of midazolam and ketamine

Alderson

Lerman

1994

Can J Anaesth

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To compare the clinical characteristics of two oral premedicants, midazolam and ketamine, 40 healthy children, one to six years of age, who were scheduled for ambulatory dental surgery, were assigned to receive either oral midazolam 0.5 mg.kg-1 or oral ketamine 5.0 mg.kg-1 in a double-blind, randomized study. Sedation and anxiolysis scores before induction, cooperation at induction of anaesthesia and recovery times and complications were assessed. We found that both drugs effectively sedated the children within 20 min of administration. Although sedated, 10% of the children in the midazolam group and 20% of those in the ketamine group became tearful on separation from their parents and 20% of those in the midazolam group and 35% of those in the ketamine group became tearful when the facemask was applied. No important side effects were attributable to either premedication. The time until the children were fit for discharge from the hospital after midazolam was approximately 20 min less than after ketamine. In conclusion, midazolam and ketamine offer similar clinical characteristics when used as oral premedications for children undergoing ambulatory surgery, although the time to discharge from hospital may be more rapid after midazolam than after ketamine.

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Oral ketamine

Cited by 6 publications

References 2 publications

Oral Ketamine or Midazolam or Low Dose Combination for Premedication in Children

Oral Ketamine or Midazolam or Low Dose Combination for Premedication in Children

Efficacy and safety of premedication with oral ketamine for day‐case adenoidectomy compared with rectal diazepam/diclofenac and EMLA^®

Oral premedication for paediatric ambulatory anaesthesia: a comparison of midazolam and ketamine

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Oral ketamine

Cited by 6 publications

References 2 publications

Oral Ketamine or Midazolam or Low Dose Combination for Premedication in Children

Oral Ketamine or Midazolam or Low Dose Combination for Premedication in Children

Efficacy and safety of premedication with oral ketamine for day‐case adenoidectomy compared with rectal diazepam/diclofenac and EMLA®

Oral premedication for paediatric ambulatory anaesthesia: a comparison of midazolam and ketamine

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Product

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Efficacy and safety of premedication with oral ketamine for day‐case adenoidectomy compared with rectal diazepam/diclofenac and EMLA^®