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Nasal ketamine for paediatric premedication
1Department of Anaesthesia, Hillel Yaffe Medical Center, Hadera, Israel.
Insights
Nasal ketamine provided superior preanesthetic sedation in children aged two to five years compared to intramuscular promethazine and meperidine. This study suggests nasal ketamine is a viable alternative for pediatric sedation before surgery.
Area of Science:
- Anesthesiology
- Pediatric Medicine
- Pharmacology
Background:
- Preanesthetic sedation is crucial for pediatric surgical patients.
- Intramuscular (IM) injections can be painful and distressing for children.
- Alternative, less invasive sedation methods are needed.
Purpose of the Study:
- To evaluate the efficacy of nasal ketamine for preanesthetic sedation in young children.
- To compare nasal ketamine with traditional IM promethazine and meperidine sedation.
Main Methods:
- A comparative study involving 86 healthy children (2-5 years) receiving nasal ketamine (6 mg/kg).
- A control group of 62 children (2-5 years) received IM promethazine and meperidine (1 mg/kg each).
- Sedation quality and salivation were assessed before elective surgery.
Main Results:
- Nasal ketamine resulted in significantly higher rates of excellent or adequate sedation (67/86) compared to the IM group (21/62) (P < 0.05).
- Salivation levels were comparable between the two groups.
- Nasal ketamine was administered 20-40 minutes prior to surgery.
Conclusions:
- Nasal ketamine is an effective and well-tolerated alternative for preanesthetic sedation in children aged 2-5 years.
- It offers a less invasive option compared to IM injections for pediatric surgical sedation.
Abstract:
Ketamine in a dose of 6 mg.kg-1 was nasally administered in 86 healthy children (ASA I and II), aged from two to five years undergoing elective general, urological or plastic surgery, 20 to 40 min before the scheduled surgery time. These children were compared with 62 others, also aged from two to five years, in whom promethazine and meperidine, 1 mg.kg-1 of each, were injected im. Sedation was started as excellent in 48 and as adequate in 19 children in the ketamine group, compared with nine and 12 respectively in Group 2 (P < 0.05), while salivation was similar in both groups. We conclude that nasal ketamine is an alternative to im preanaesthetic sedation administration in children aged from two to five years.