Comparison of nebulised dexmedetomidine versus nebulised ketamine versus nebulised dexmedetomidine-ketamine as premedication in peadiatric surgery

Gadkari Charuta, Jirapure Rushikesh, Deshmukh Shubhada, Wakode Neha, Bhure Anjali

Abstract


Aim and Objectives: The present study was undertaken to compare the efficacy of nebulized dexmedetomidine, nebulized ketamine and combination of nebulised dexmedetomidine and ketamine for premedication in pediatric patients.
Materials and Methods: Total 75 children aged between 3-6 years, ASA grade I and II, posted for elective surgery were enrolled and divided into three equal groups. Group D was premedicated with nebulized dexmedetomidine (2mcg/kg), group K was premedicated with nebulized ketamine (2 mg/kg), and group DK was premedicated with combined nebulized dexmedetomidine and ketamine (1 mcg/kg + 1 mg/kg). Primarily, patients were assessed for level of sedation, parental separation and mask acceptance at induction. Secondary assessments were hemodynamic parameters and immediate side effects if any.
Results: Studied groups were comparable as regards to demographic data and haemodynamic parameters. At all-time intervals except at 20 minutes, mean sedation scores were comparable among the three groups (p>0.05). At 20 minutes, group K had significantly higher sedation scores when compared to group D and group DK. The mean parental separation scores of group D, group DK and group K were 1.65 0.48, 1.62  0.49 and 1.37 0.49 respectively, (p>0.05). The mean mask acceptance score of group D, group DK and group K were 1.73 0.54, 1.73 0.68 and 1.43 0.66 respectively, (p>0.05). None of the patient had any immediate side effects.
Conclusion: Dexmedetomidine (2mcg/kg), Ketamine (2mg/kg) and combination of Dexmedetomidine and Ketamine (1mcg/kg and 1mg/kg) as premedication via nebulisation route in pediatric patients is efficacious
and safe. Combination of dexmedetomidine and ketamine did not increase the success of premedication. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons

Keywords: Premedication, Nebulization, Dexmedetomidine, Ketamine, Sedatio, Induction.


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