[Oral premedication with midasolam and ketamine in children with neurosurgical diseases]

Area of Science:

• Pediatric Neurosurgery
• Anesthesiology
• Pharmacology

Background:

• Premedication is crucial for managing anxiety and ensuring safety in pediatric neurosurgery.
• Oral administration offers a non-invasive route for premedication in children.
• Evaluating different oral premedication regimens is essential for optimizing patient care.

Purpose of the Study:

• To assess the efficacy and safety of two oral premedication strategies in children undergoing elective neurosurgery.
• To compare a combination of midazolam and ketamine with midazolam alone for oral premedication.

Main Methods:

• A study involving 100 children (aged 2-10 years) with intracranial neurosurgical pathology.
• Two groups received oral premedication: Group 1 (midazolam 0.5 mg/kg + ketamine 3 mg/kg) and Group 2 (midazolam 0.75 mg/kg).
• Agents were diluted with medical or sweet syrups; efficacy and sedation were evaluated.

Main Results:

• An effective anxiolytic effect was observed in 92% of Group 1 and 80% of Group 2.
• A more pronounced sedative effect was noted in the midazolam-ketamine combination group.
• The mean time to achieve the desired effect was 20 minutes, with no serious complications reported for either regimen.

Conclusions:

• Both oral premedication regimens (midazolam-ketamine and midazolam alone) are effective and safe for pediatric neurosurgery patients.
• The combination of midazolam and ketamine may offer enhanced sedation.
• Oral premedication should be considered a valuable tool for preparing children with neurosurgical conditions for elective procedures.