Comparison of intranasal ketamine and intranasal midazolam for pediatric premedication in patients undergoing congenital heart disease surgery
Virali Trivedi, Indu Verma, RamN Sharma, SandeepS Dhaked
Abstract
Background Premedication via intranasal route has been studied for various types of surgeries, but there are only few studies reported in patients undergoing congenital heart disease correction surgeries. Intranasal premedication in pediatric patients undergoing congenital heart disease surgery is much more useful, as there is no need for intramuscular and intravenous injections that will cause pain and anxiety to patients and cause the child to cry, thus creating hemodynamic instability in compromised heart patients. In our study, the authors compared the efficacy and side effects of ketamine and midazolam administered with a nasal mucosal atomizer (MAD).Methods A total of 60 patients with ASA grade II and III undergoing congenital heart disease surgeries were randomly allocated into two groups: group A (ketamine) and group B (midazolam). These drugs were given intranasally on the mucosal surface with an atomizer. The primary variables were onset of sedation, separation from parents, degree of sedation, response to venipuncture, and acceptance of face mask.Results The sedation score was higher in the midazolam group as compared with the ketamine group (P<0.05) and the mean time of onset of sedation in the midazolam group was 10.66 min as compared with 15.16 min in the ketamine group which was statistically significant, with the P value of 0.005.Conclusion Midazolam has an early onset of sedation and is associated with no side effects.