EFFICACY AND SAFETY OF ORAL KETAMINE PREMEDICATION IN CHILDREN UNDERGOING DAY CASE SURGERY

Area of Science:

• Anesthesiology
• Pediatric Medicine
• Pharmacology

Background:

• Oral premedication is infrequently used for pediatric patients in Nigeria, leading to distress for children and parents.
• Anxiety and psychological distress are common in children undergoing surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of oral ketamine as a premedication in children undergoing ambulatory surgeries.
• To assess the impact of oral ketamine on sedation, anxiolysis, and behavior during anesthetic induction.

Main Methods:

• A prospective study involving 73 children (1-6 years, ASA I-II) randomly assigned to receive oral ketamine (5 mg/kg or 10 mg/kg) or no premedication.
• Observations included acceptance of premedication, sedation, anxiolysis, behavior during separation, intravenous access, mask acceptance, and post-anesthetic recovery.

Main Results:

• Oral ketamine was well-tolerated in both dosage groups.
• Adequate sedation and anxiolysis were achieved in 52-84% (5 mg/kg) and 68-88% (10 mg/kg) of children.
• The 10 mg/kg dose showed superior results in satisfactory behavior at separation (82.6%) and mask acceptance (64%) compared to other groups. No adverse effects were reported.

Conclusions:

• Oral ketamine is an acceptable and safe premedication option for pediatric patients.
• It effectively provides sedation, reduces anxiety, and improves cooperation during anesthetic procedures.
• The study supports the use of oral ketamine for pediatric premedication, especially in settings where it is uncommon.