Sweet Sedation: Honey Based Midazolam Versus Ketamine In Pediatric Anesthesia Premedication

Abstract

population. Anxiety and separation from parents is worrisome and there are no ideal premedications to calm the pediatric patients. Hence this comparative study of effects of Midazolam with honey & Ketamine with honey as oral premedication.

Methods: This study was undertaken in different specialties of surgery department, 100 patients of either sex, aged between 2-8 years were taken and randomly assigned into 2 groups of 50 patients each; patients were selected by process of exclusion at every step for any variation from normal.  Patients of both groups were premedicated orally with parenteral preparation of midazolam & ketamine mixing with honey (0.2ml/kg body weight).

Group M     Midazolam 0.75 mg/kg body weight.

Group K      Ketamine 6mg/kg body weight.

Both the drugs were given 30 minutes prior to proposed time of induction.

Patients were observed and compared in between the two groups and results were tabulated.

Results:  Onset of sedation in midazolam group was 16.2± 3.6mins & in ketamine group 19.4 3.2 mins, 66% patients were calm & sleepy compared to 56% with ketamine during separation from their parents, 54% patients in midazolam group were unafraid and cooperative during application of facemask compared to 44% in ketamine group, level of sedation was satisfactory & similar in both groups. In group M patients who received midazolam orally; onset of sedation was quicker (P < 0.001), number of patients calm and sleepy during separation from their parents and at the time of venepuncture were more silent (P > 0.05) and degree of induction score was superior (P <0.05). Undesired effects like increased secretion, vomiting, nystagmus, random limb movement, and excitement before & after surgery were more in ketamine group. 

Conclusion: Both midazolam (0.75mg/kg) and ketamine (6mg/kg) can be used as oral premedicants for children. However, midazolam may be preferred because of its early onset of action, better effect on allaying anxiety during separation from parents and lesser side effects.