The efficacy of oral ketamine or dexmedetomidine as anesthetic premedication in children had been evaluated either alone or in combination with other medication. In our study we use combination of ketamine and dexmedetomidine as oral premedication in children and compare it with ketamine alone in sixty children aged two to seven years, ASA grade 1, undergoing surgery of more than 45 min expected duration. The children were randomly allocated to one of two study groups: Group I received oral ketamine 6 mg/kg'1 and Group H received oral ketamine 3 mg kg' plus oral dexmedetomidine 3 fig kg'1. About thirty minutes before induction, premedication was given. Before medication and every 5 min thereafter, sedation and emotional status were assessed. When condition of patient was accepted pulse oximeter was connected to monitor SpO2 and heart rate. Children were observed for onset of sedation and any side effects Twenty five minutes after oral premedication, child was transferred with a parent to the operating room entrance. The child's condition was evaluated after 30 min by the anesthetist during separation from parent and during vein-puncture and graded. Children in GPII considerably more sedated and had significantly better reaction to separation from parents than that in GP I. Also, they were judged sedated enough to attempt insertion of the intravenous catheter before induction of anesthesia. Side effects like vomiting, salivation, hallucination and hiccough were more in GP I patients. Bradycardia and de-saturation occurred in one patient in GP IIpreoperatively. This study provide evidence that a combination of dexmedetomidine and ketamine as oral premedication in children was better effect and less side effects than ketamine alone. |
