PREMEDICATION IN HYPERIRRITABLE CHILDREN USING SUBANAESTHETIC DOSES OF INTRAMUSCULAR KETAMINE

Area of Science:

• Anesthesiology
• Pediatric Anesthesia
• Pharmacology

Background:

• Preoperative anxiety in children significantly impacts anesthesia induction.
• Effective premedicants are crucial for managing uncooperative pediatric patients.
• Subanesthetic ketamine offers potential as a preanesthetic agent.

Purpose of the Study:

• To evaluate the efficacy of intramuscular ketamine at subanesthetic doses as a premedicant in highly uncooperative children.
• To compare the effects of two different doses of ketamine (2 mg/kg vs. 4 mg/kg) on sedation and patient response.
• To assess the safety and suitability of ketamine preanesthesia in pediatric patients.

Main Methods:

• A randomized study involving 40 uncooperative children aged 1-7 years.
• Two groups received either 2 mg/kg or 4 mg/kg of intramuscular ketamine 10 minutes before anesthesia induction.
• Sedation levels, response to separation, venipuncture, and postoperative state were assessed.

Main Results:

• The 4 mg/kg ketamine group showed 100% uniform and predictable sedation, compared to 75% in the 2 mg/kg group.
• Favorable responses to separation and IV access were higher in the 4 mg/kg group (100%) versus the 2 mg/kg group (65-75%).
• Smooth induction and recovery were observed in both groups, with no emergence delirium.

Conclusions:

• Intramuscular ketamine at a subanesthetic dose of 4 mg/kg is an ideal premedicant for irritable and uncooperative pediatric patients.
• Preanesthetic medication should be individualized based on patient anxiety levels.
• Ketamine offers a safe and effective option for pediatric preanesthesia, improving patient cooperation and reducing anxiety.