Naderi Nima, Emami Soodabeh, Banifatemi Mahsa, Ghadimi Maryam, Shahriari Ensieh, Sahmeddini Mohammad Ali
Shiraz University of Medical Sciences, Anesthesiology and Critical Care Research Center, Shiraz, Iran.
Turk Arch Otorhinolaryngol. 2025 Jan 10;62(3):113-119. doi: 10.4274/tao.2024.2023-12-14.
A pre-anesthetic medication that is ideal for pediatric patients undergoing tonsillectomy should alleviate pediatric anxiety, facilitate the smooth induction of anesthesia, and have an analgesic effect for postoperative care. This study compared the effectiveness of an oral combination of midazolam and ketamine (MK) with an oral combination of chloral hydrate and meperidine (CM) as premedication in pediatric patients undergoing tonsillectomy.
This double-blind clinical trial study was conducted with 68 pediatric patients scheduled to undergo tonsillectomy. The participants were randomly allocated into two groups: the CM group, which received oral premedication of 50 mg/kg chloral hydrate and 1.5 mg/kg meperidine, and the MK mixture group, which received oral premedication of 0.5 mg/kg midazolam and 5 mg/kg ketamine. Various parameters such as separation anxiety, agitation during emergence from anesthesia, postoperative pain, postoperative nausea, and vomiting, as well as respiratory depression within a 6-hour period following anesthesia, were carefully recorded and observed.
There were no differences between the two groups in terms of separation anxiety (p>0.05) and post-surgery pain scores (p=0.12). Regarding postoperative agitation, there were significantly more patients in an awake but calm state in the CM group than in the MK (44% vs. 17.64%, p=0.01). The incidence of nausea and vomiting was lower in the CM than in the MK group (47% vs. 76.5%, p=0.02).
This study shows that an oral mixture of CM is more suitable as pre-anesthetic medication in pediatric patients undergoing tonsillectomy than a MK.
一种适用于接受扁桃体切除术的儿科患者的麻醉前用药应能减轻儿科患者的焦虑情绪，促进麻醉的平稳诱导，并对术后护理具有镇痛作用。本研究比较了咪达唑仑和氯胺酮口服合剂（MK）与水合氯醛和哌替啶口服合剂（CM）作为接受扁桃体切除术的儿科患者术前用药的有效性。
本双盲临床试验研究针对68例计划接受扁桃体切除术的儿科患者进行。参与者被随机分为两组：CM组，接受50mg/kg水合氯醛和1.5mg/kg哌替啶的口服术前用药；MK合剂组，接受0.5mg/kg咪达唑仑和5mg/kg氯胺酮的口服术前用药。仔细记录并观察各种参数，如分离焦虑、麻醉苏醒期的躁动、术后疼痛、术后恶心和呕吐，以及麻醉后6小时内的呼吸抑制情况。
两组在分离焦虑（p>0.05）和术后疼痛评分（p=0.12）方面无差异。关于术后躁动，CM组清醒但平静状态的患者明显多于MK组（44%对17.64%，p=0.01）。CM组恶心和呕吐的发生率低于MK组（47%对76.5%，p=0.02）。
本研究表明，对于接受扁桃体切除术的儿科患者，CM口服合剂作为麻醉前用药比MK更合适。
