Effects of ketamine and ketamine with midazolam on emergence agitation in children following sevoflurane anesthesia

  • Achyut Sharma National Academy of Medical Sciences http://orcid.org/0000-0002-0607-5148
  • Resham Bahadur Rana Director Devdaha Medical College and Research Institute Pvt. Ltd., Rupandehi
Keywords: emergence agitation; ketamine; sevoflurane;

Abstract

Background:
Emergence agitation is a distressful phenomenon
associated with inhalational agents such as
Sevoflurane in short surgical procedures. Various
drugs have been used in the past but some come at
the cost of increased complications. We aim to study
the effects of ketamine alone and ketamine with
midazolam on emergence agitation and their effects
on recovery and discharge times.

Methods:
We conducted a prospective randomized controlled
trial among 94 patients aged two to ten years
presenting for ophthalmic surgeries in which 45
patients were allocated to each group: group K
(Ketamine) and group KM (Ketamine with
Midazolam). Group K received Ketamine 0.3 mg/kg
IV and Group KM received Ketamine 0.3 mg/kg IV
and Midazolam 0.03 mg/kg IV. Intraoperatively heart
rate and post-operatively emergence agitation,
recovery times, discharge times were studied.

Results:
Demographic variables were comparable between
the two groups. Median Pediatric Anesthesia
Emergence Delirium score of 6 with IQR (4-6)
in group K was comparable to the median score of 5
with IQR (4-6) in group KM. The mean recovery time
of 22±4.82 min in group K was significantly lower
compared to the mean time of 25.75±3.32 min in
group KM. Mean time to discharge of 67±11 min
from the hospital in group K was significantly shorter
compared to that in group KM (108±18 mins).

Conclusion:
We concluded from our study that ketamine alone is
as effective as ketamine with midazolam in reducing
the emergence agitation following Sevoflurane
anesthesia for ophthalmic surgery.

Author Biographies

Achyut Sharma, National Academy of Medical Sciences
Anesthesiologist, Nepal Mediciti Hospital, Lalitpur
Resham Bahadur Rana, Director Devdaha Medical College and Research Institute Pvt. Ltd., Rupandehi
Director

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Published
2018-08-06
How to Cite
Sharma, A., & Rana, R. (2018). Effects of ketamine and ketamine with midazolam on emergence agitation in children following sevoflurane anesthesia. Journal of Society of Anesthesiologists of Nepal, 4(2), 57-65. Retrieved from http://www.jsan.org.np/jsan/index.php/jsan/article/view/198
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Original Article