Comparison of oral premedication with midazolam-ketamin, midazolam and diazepam in pediatric cases

49 Vm-SUMMARY Comparision of Oral Premedication with Midazolam-Ketamin, Midazolam and Diazepam in Pediatric Cases Anesthesia and surgery thought makes the children stressfull. With a proper premedication anxiety can be prevented, pschological travma can be minimized and induction of anesthesia can be easier. In this study we examined midazolam-ketamin combination and midazolam and diazepam administration as premedication in children and its effectiveness and effects on hemodynamic and respiratory parameters were evaluated 60 cases operated in pediatric surgery, ENT surgery, orthopaedic surgery and ophthalmic surgery theaters were divided into 3 grups of 20 patients each in a randomized pattern ( ASA rise score 1-2, age 1-10 years ). All cases were premedicated 30 minute before operation with Diazepam 0.2mg/kg and atropin 0.02mg/kg or Midazolam 0.5mg/kg and atropin 0.02mg/kg or Midazolam 0.3mg/kg and Ketamine 5mg/kg and atropin 0.02 mg/kg in a maximal volume of 0.4 mg/kg cherry drink. Patients were evaluated for sedation scores, anxiety scores and respiratory and hemodinamik effects in any 15 minutes induction period, during post operative period and in the postoperative recovery room. Induction of anesthesia was obtained with 2-4 mg/kg propofol and 20 jig/ kg alfentany after venous canulation. In cases where venous canulation could not be performed, induction was obtained with inhalation anesthetics. Anesthesia was maintained with 50 % 02, 50 % N2 O and 0.5-1 % Isoflurane after tracheal intubation or placement of laryngeal mask airway. Patients were evaluated postoperatively for propable complications, nause-vomiting, additional analgesic requirement, amnesia and satisfaction from the metod. Results were evaluated statistically.. There was no difference between the grups in distribution of age, sex, weight and duration of operation. Sedation scores were significantly higher in Group 3 for 15 min, 30min and induction period evaluations. For face mask tolerance, anxiety score were better in Group 2 and Group3. Additionally separation from the patents were easier in Groups 1 and 2, but it decreased significantly in Group 3 at time 15 min. and 30 min. Mean Arterial Pressure did not change in Grups 1 and 2, but it decreased significantly in group 3 at time 15 min. and 30 min. There was no statistically significant difference between the grups for heart rate, oxgen saturation and respiratory rate. We concluded that oral midazolam-ketamine combination can be administrened easily and safely to provide sufficient sedation, comfortable anesthesia induction and postoperative recovery for pediatric premedication