Oral ketamine premedication in children (placebo controlled double-blind study)

Abstract

Ketamine 3-6 mg kg-1 given by mouth to paediatric patients for anaesthetic premedication was evaluated. Forty-three children, ages 2-9 years were randomly allocated to receive either ketamine (3 or 6 mg kg-1) or placebo (cola 0.2 mL kg-1). Oral use of ketamine made separation from the families easier, gave an increased level of sedation, made acceptance of mask application easier and improved the emotional state in the recovery phase. These improvements were present with ketamine 3 mg kg-1 and 6 mg kg-1 in comparison with the placebo. We conclude that 3 mg kg-1 ketamine given by mouth to premedicate paediatric patients is as effective as 6 mg kg-1 but has a decreased incidence of side effects such as nystagmus and vomiting.

Oral premedication in children: A randomized study of a combination of oral midazolam, ketamine with atropine vs midazolam and atropine vs ketamine and atropine

“…Then on different doses of ketamine have been tried in pediatric oral premedication. 7,12 Administration of oral premedication in late half an hour or one hour prior to induction was shown to be effective and not associated with regurgitation or aspiration during induction. 4 Intravenous ketamine administered is well known to cause side effects like hallucination, increased oral secretion, nystagmus etc.…”

“…Both starts acting after a time gap of 15-20 minutes and produce a calm child for anaesthesia at the end 30 minutes. [7][8][9][10] Midazolam is a water-soluble, short-acting benzodiazepine with rapid onset, short duration of action. It is an anxiolytic and sedative agent with minimal side effects.Ketamine is a phencyclidine derivative which acts on the n-methyl d-aspartate receptors and causes central dissociation of the cerebral cortex while providing amnesia and analgesia and applied for premedication in different studies.…”

Ansiedade, a criança e os pais

“…Pode ser administrada por via oral (3 a 5 mg.kg -1 ), nasal (3 a 5 mg.kg -1 ), muscular (2 a 5 mg.kg -1 ), transmucosa (5 a 6 mg.kg -1 ) e retal (5 mg.kg -1 ) 63,64 . Quando administrada por via oral, o tempo de latência para a sedação é de aproximadamente 20 minutos 64 . A cetamina pode provocar agitação e alucinação durante o período pós-operatório.…”

“…It may be orally (3 to 5 mg.kg -1 ), nasally (3 to 5 mg.kg -1 ), muscularly (2 to 5 mg.kg -1 ), transmucousally (5 to 6 mg.kg -1 ) and rectally (5 mg.kg -1 ) administered 63,64 . When orally administered, sedation onset is approximately 20 minutes 64 . Ketamine may promote postoperative agitation and hallucination.…”

A double blinded comparative study of oral premedication in children with midazolam alone or in combination with ketamine

“…8,9 Ketamine has similar pharmacodynamics after oral administration and has been investigated as an alternative. [10][11][12][13] However, when used as a sole premedicate, it has not been found to be very effective but may cause excessive secretions, dysphoria, and hallucinations. 14,15 The addition of different doses of ketamine to oral midazolam has been tried and found to have varying results on the success rate of premedication with low but variable side effect profile.…”