Oral midazolam combined with ketamine for premedication in children

Objective To compare the sedative effect,the onset time and children receiving rate of three different premedication methods: intramuscular ketamine,oral ketamine and oral midazolam and ketamine in mixture.Methods Ninety patients before paediatric surgery were divided into 3 groups randomly: intramuscular ketamine 5 mg / kg(group A),oral ketamine 6 mg / kg alone(group B),or oral midazolam 0.5 mg / kg and ketamine 3 mg / kg(group C),respectively.The parameters included sedation score before anaesthesia,reaction to separation with parents were observed,and children’s behavior changes were assessed on the first day and the seventh day after operation.Results The acceptance rate was only 10% in group A,while were both above 90% in group B and C.Compared with group B,group C had a faster onset time,better effect of sedation;On the first postoperative day and on the seventh day follow-up,preoperative intramuscular injection had a higher rate of behavior changes.Conclusion Premedication with oral midazolam and ketamine is effective and well accepted by paediatric surgery patients,and can avoid psychological harm to children,it is suitable for pediatric premedication.