[Rectal premedication using ketamine, diazepam and atropine in childhood]

In 70 children aged between 2 and 14 years the effect of rectal application of ketamine, diazepam and atropine was investigated. Administration was effected by suppositories in 38 children (group A) in four weight classes. Thirty-two children (group B) were premedicated by clysters depending on body weight. We found that the combination of drugs applied in group B showed significantly more effective premedication and enabled smooth induction of anaesthesia. Latency between application and induction was 20 minutes. Since a state of deep sleep can occur rapidly, a preoperative monitoring of the children is necessary. In contrast to group A, we found a smaller increase in heart rate in group B. But there were no differences in behaviour during and after operation between the groups. Despite the relatively small doses of ketamine, 12.8% of all children showed increased salivation. Therefore, this method of premedication should not be used without atropine. Since 11% of the patients vomited postoperatively, the use of dehydrobenzperidol instead of diazepam is discussed.