This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Beebe, D. S. Articles by Palahniuk, R. J. Search for Related Content PubMed PubMed Citation Articles by Beebe, D. S. Articles by Palahniuk, R. J.

Effectiveness of Preoperative Sedation With Rectal Midazolam, Ketamine, or Their Combination in Young Children

Departments of Anesthesiology and Pediatrics, University of Minnesota Hospitals and Clinics, Minneapolis, Minnesota

To determine which of three types of rectal sedation was most effective preoperatively in facilitating parental separation and intravenous cannulation in young children, 100 children 3.0 ± 1.7 (mean ± SD) yr of age were randomly assigned to four equal groups. One group (M-K-A) received rectal midazolam (0.5 mg/kg), ketamine (3 mg/kg), and atropine (0.02 mg/kg). The other sedation groups received the same doses of midazolam and atropine (M-A) or ketamine and atropine (K-A) alone, and the control group (A) received only rectal atropine. Most children in either the M-K-A (100%) or M-A (92%) groups separated easily from their parents without struggling or crying, significantly more than in the K-A (60%) or A (64%) groups. However, more children in the M-K-A group (44%) were asleep during separation than in the M-A group (8%; P < 0.05). Only 20% of the children in the M-A or M-K-A groups cried during intravenous catheter placement, significantly less than in the K-A (56%) or A (92%) groups. Intravenous catheter placement was also successful significantly more often in the M-A (80%) and M-K-A (84%) groups than in the K-A (48%) or A (40%) groups. Complications were similar among the groups, but there was evidence that midazolam prolonged recovery time in some patients. Rectal midazolam with or without ketamine is a useful technique when intravenous catheter placement before induction of anesthesia is desired.

This article has been cited by other articles:

				M. Tanaka, T. Nishikawa, and P. Marhofer Rectal S(+)-Ketamine for Pediatric Premedication Response Anesth. Analg., November 1, 2001; 93(5): 1363 - 1364. [Full Text]

				P. Marhofer, H. Freitag, A. Hochtl, M. Greher, W. Erlacher, and M. Semsroth S(+)-Ketamine for Rectal Premedication in Children Anesth. Analg., January 1, 2001; 92(1): 62 - 65. [Abstract] [Full Text] [PDF]

				Committee on Drugs Alternative Routes of Drug Administration---Advantages and Disadvantages (Subject Review) Pediatrics, July 1, 1997; 100(1): 143 - 152. [Abstract] [Full Text] [PDF]

				R. I. Parker, R. A. Mahan, D. Giugliano, and M. M. Parker Efficacy and Safety of Intravenous Midazolam and Ketamine as Sedation for Therapeutic and Diagnostic Procedures in Children Pediatrics, March 1, 1997; 99(3): 427 - 431. [Abstract] [Full Text] [PDF]