Ketamine and midazolam as procedural sedation in children: a structured literature review and narrative synthesis
In paediatric patients the alleviation of preoperative anxiety is key to ensuring a smooth anaesthetic, and studies have shown that a pleasant induction is able to prevent adverse postoperative behavioural changes. Oral midazolam and ketamine in combination have been used as premedication to ameliorate this anxiety, but the utility of this combination remains unclear. The authors conducted a systematic review and narrative synthesis of randomised controlled trials testing the effectiveness of the combination of oral midazolam and ketamine versus midazolam alone as preanaesthetic sedation in children aged one to 15 years of age undergoing elective paediatric surgery. Ten trials were included in this analysis. Trials using combinations of midazolam (0.25 to 0.3 mg.kg-1) and ketamine (2 to 3 mg.kg-1) provided higher quality sedation with a similar or better side-effect profile than midazolam 0.5 mg.kg-1 alone, without prolonging recovery time.
The full article is available at https://doi.org/10.36303/SAJAA.2020.26.1.2302
By submitting manuscripts to SAJAA, authors of original articles are assigning copyright to the SA Society of Anaesthesiologists. Authors may use their own work after publication without written permission, provided they acknowledge the original source. Individuals and academic institutions may freely copy and distribute articles published in SAJAA for educational and research purposes without obtaining permission.
The work is licensed under a Creative Commons Attribution-Non-Commercial Works 4.0 South Africa License. The SAJAA does not hold itself responsible for statements made by the authors.