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Comparison of effects of intravenous midazolam and ketamine on emergence agitation in children: Randomized controlled trial.

ABSTRACT: A prospective, double-blind, randomized controlled trial to compare the effect of preoperative midazolam or ketamine on the incidence of emergence agitation (EA) following sevoflurane anaesthesia in children.Paediatric patients (2-6 years old) undergoing ophthalmic surgery were allocated to receive premedication with either 0.1?mg/kg midazolam or 1?mg/kg ketamine. Incidence of EA and postoperative pain scores were recorded at 10-min intervals in the postanaesthetic care unit (PACU). The use of EA rescue medications (fentanyl or midazolam) was recorded.The incidence of EA was significantly lower in the ketamine group (n?=?33) than the midazolam group (n?=?34) at 10 and 20?min after transfer to PACU. There was no significant difference in overall incidence of EA. The frequency of midazolam use as rescue medication was significantly lower in the katamine group than in the midazolam group.Premedication with ketamine is more effective than midazolam in preventing EA during the early emergence period after sevoflurane anaesthesia in children.

SUBMITTER: Kim KM

PROVIDER: S-EPMC5580063 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Comparison of effects of intravenous midazolam and ketamine on emergence agitation in children: Randomized controlled trial.

Kim Kyung Mi KM Lee Ki Hwa KH Kim Yong Han YH Ko Myoung Jin MJ Jung Jae-Wook JW Kang Eunsu E

The Journal of international medical research 20160215 2

<h4>Objective</h4>A prospective, double-blind, randomized controlled trial to compare the effect of preoperative midazolam or ketamine on the incidence of emergence agitation (EA) following sevoflurane anaesthesia in children.<h4>Methods</h4>Paediatric patients (2-6 years old) undergoing ophthalmic surgery were allocated to receive premedication with either 0.1 mg/kg midazolam or 1 mg/kg ketamine. Incidence of EA and postoperative pain scores were recorded at 10-min intervals in the postanaesthe ...[more]

PMID: 26880794

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Project description:BACKGROUND:Emergence agitation (EA) is a common postoperative issue in children that causes self-injury, increases stress on healthcare team members, and even leads to postoperative maladaptive behavioral changes in children. Clear answers regarding a 'gold standard' for prevention of EA are not available. Pain is regarded as an important causative factor of EA, and ultrasound-guided lumbar plexus block is a safe and efficient anesthetic method that can provide satisfactory pain relief in pediatric hip surgery. The purpose of our study is to determine whether ultrasound-guided lumbar plexus block can reduce the incidence of EA in children undergoing hip surgery. METHODS/DESIGN:We designed a prospective, randomized, controlled, blinded trial to determine the effect of ultrasound-guided lumbar plexus block on EA. A total of 100 American Society of Anesthesiologists class I-II children (1-6?years old) scheduled for elective hip surgery will be recruited for this study. Participants will be randomized at a 1:1 ratio to receive either ultrasound-guided lumbar plexus block or fentanyl after the induction of general anesthesia. The primary outcome is the incidence of EA 30?min after emergence from anesthesia using the Pediatric Anesthesia Emergence Delirium (PAED) score. The secondary outcomes are the severity and duration of EA 30?min after emergence from anesthesia using the PAED score, postoperative pain evaluated by the Children's Hospital of Eastern Ontario Pain Scale, and the incidence of postoperative adverse events. Randomization will be conducted using a computer-generated randomization schedule. Outcome assessors and data collectors will be blinded to the group allocations. Assessments will be performed before surgery, intraoperatively, and postoperatively at every time point. DISCUSSION:Our hypothesis in this trial is that ultrasound-guided lumbar plexus block can decrease the incidence of EA in children undergoing elective hip surgery. This trial will provide clinical answers to verify our hypothesis. If our hypothesis is confirmed, the results could provide a safe method to prevent EA. TRIAL REGISTRATION:Chinese Clinical Trial Registry, ChiCTR-INR-17011525 . Registered on 30 May 2017.

Dataset Information

Comparison of effects of intravenous midazolam and ketamine on emergence agitation in children: Randomized controlled trial.

Publications

Comparison of effects of intravenous midazolam and ketamine on emergence agitation in children: Randomized controlled trial.

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