Midazolam premedication in attenuating ketamine psychic sequelae

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Ketamine is a dissociative anesthetic agent.
• Ketamine can cause undesirable psychic sequelae, including emergence delirium and unpleasant dreams.
• Midazolam is a benzodiazepine often used for premedication.

Purpose of the Study:

• To assess the efficacy of midazolam premedication in mitigating the psychological adverse effects associated with ketamine anesthesia.
• To evaluate the impact of midazolam on excitatory phenomena, emergence delirium, and dream disturbances post-ketamine administration.

Main Methods:

• A study involving 60 patients undergoing short surgical or urological procedures.
• Patients received intravenous midazolam (0.05 mg/kg) 5 minutes prior to intravenous ketamine induction (1 mg/kg).
• Psychic sequelae, including excitatory effects, delirium, and dreams, were systematically recorded post-operatively.

Main Results:

• A low incidence of adverse psychic effects was observed: 15% experienced excitatory effects, 8% had mild delirium, and 3% reported unpleasant dreams.
• Patient acceptability of ketamine anesthesia, when preceded by midazolam, was notably high at 100%.

Conclusions:

• Midazolam premedication is a safe and effective strategy for attenuating the psychic sequelae of ketamine anesthesia.
• The combination of midazolam and ketamine enhances patient comfort and acceptance of the anesthetic procedure.