Oyedepo O O, Nasir A A, Abdur-Rahman L O, Kolawole I K, Bolaji B O, Ige O A
Department of Anaesthesia, College of Health Sciences, University of Ilorin, Ilorin, Nigeria.
Department of Surgery, College of Health Sciences, University of Ilorin, Ilorin, Nigeria.
J West Afr Coll Surg. 2016 Jan-Mar;6(1):1-15.
Oral premedication for paediatric age group is an uncommon practice amongst anaesthetists in Nigeria. Both parents and the child suffer some form of emotional or psychological distress.
To determine the efficacy and safety of oral formulated ketamine for premedication in children scheduled for ambulatory surgeries.
Seventy three children aged 1 - 6 years with American Society of Anesthesiologists (ASA) physical status I-II were prospectively studied. They were assigned randomly to receive either 5 mg/kg (Group A), 10 mg/kg (Group B), or no ketamine (Group C).The children were observed for acceptance of premedication, sedation and anxiolysis at 10, 20 and 30 minutes after drug administration. Behavior/response of each child at the time of separation from parents, intravenous access, and acceptance of facemask for induction, postanaesthetic arousal state and complications were also recorded.
There were 73 children in this study with a mean age of 37.4±18.0 months. The groups were comparable in age. The studied agent was tolerated by both groups that received premedication with no significant difference (P 0.73). Adequate sedation and anxiolysis were observed in groups A and B, (52%, 84%) and (68%, 88%) respectively. However, more children in group B (82.6%) had satisfactory behaviour at separation from parents and a better acceptance of anaesthetic face mask (64%) at induction than those in groups A and C (33.3%, 21.7%, respectively). No side effect was recorded in either of the premedication groups or the control group.
Oral ketamine is acceptable and safe premedication for children. It provided good sedation, relieved anxiety and had no side effect in the children at the studied doses.
在尼日利亚，麻醉医生对儿童群体进行口服术前用药并不常见。父母和孩子都会遭受某种形式的情绪或心理困扰。
确定口服氯胺酮制剂用于择期门诊手术患儿术前用药的有效性和安全性。
前瞻性研究73例年龄1 - 6岁、美国麻醉医师协会（ASA）身体状况为I-II级的儿童。他们被随机分配接受5 mg/kg（A组）、10 mg/kg（B组）或不接受氯胺酮（C组）。给药后10、20和30分钟观察儿童对术前用药的接受情况、镇静和抗焦虑效果。还记录了每个儿童在与父母分离、建立静脉通路、接受诱导面罩、麻醉后苏醒状态及并发症时的行为/反应。
本研究有73例儿童，平均年龄37.4±18.0个月。各组年龄具有可比性。接受术前用药的两组对研究药物耐受性良好，无显著差异（P 0.73）。A组和B组分别有（52%，84%）和（68%，88%）观察到充分的镇静和抗焦虑效果。然而，B组中更多儿童（82.6%）在与父母分离时行为良好，诱导时对麻醉面罩的接受度更好（64%），高于A组和C组（分别为33.3%，21.7%）。术前用药组和对照组均未记录到副作用。
口服氯胺酮是儿童可接受且安全的术前用药。在所研究的剂量下，它能提供良好的镇静效果，缓解焦虑，且对儿童无副作用。
