![]() ![]() The duration of surgery was equal to or <30 min in all the cases. Patients aged between 18 and 45 years of either sex with the American society of Anesthesiologists physical grades I and II were included in the study. Institutional Ethical Committee approval (IEC No: SMVMCH/IEC/DAO/239/2014) and informed written consent from all the patients were obtained before the commencement of the study. Thirty patients posted for elective short surgeries from Departments of Obstetrics and Gynaecology, general surgery and Orthopaedics receiving ketamine with midazolam as an anesthetic agent were enrolled in our study. This study was an open-label, prospective, observational study conducted at Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India, by the Department of Pharmacology in collaboration with Department of Anesthesia between March and August 2014. In view of these attributes, the present study was designed to evaluate the effect of low dose intravenous midazolam as premedication in attenuating ketamine-induced hemodynamic instability and postanesthetic emergence delirium. Though studies are available with other premedication drugs used for ketamine anesthesia, limited data are available regarding the usefulness of the low dose midazolam combined with low-dose ketamine in preventing ketamine-induced hemodynamic instability and postanesthetic emergence phenomenon. Literature suggests that compared with a combination of ketamine with other benzodiazepines (diazepam, lorazepam), midazolam premedication results in fewer emergence reactions. ![]() ![]() Midazolam when combined with intravenous ketamine found to be safe and effective for relief of anxiety and sedation for diagnostic and therapeutic procedures. Midazolam has potent anxiolytic effect with amnesia, sedation, skeletal muscle relaxant activity, and good hemodynamic stability with lack of significant side effects in doses <0.5 mg/kg. But every benzodiazepine has its own disadvantage: More prolonged impairment of mental activity and amnesia with flunitrazepam slower onset of action and delayed recovery with lorazepam higher incidence of unpleasant dreams with diazepam. Drugs including opiates, neuroleptics, benzodiazepines, physostigmine, and alpha-2 adrenoceptor agonists have been used with varying success to prevent these emergence reactions associated with ketamine administration.Īmong the above premedication drugs, concomitant use of benzodiazepines has been proven to be satisfactory in alleviating the undesirable effects during the perioperative period. Hence, there is an ever-increasing quest to overcome these adverse effects with appropriate medication. The incidence ranges from 5% to 30% which is mostly dose related. But it has the limitations of intraoperative cardiovascular stimulation, muscular hypertonia and recovery is often associated with postoperative psychomimetic effects (emergence delirium, unpleasant dreams, and hallucinations). Ketamine is a rapidly acting dissociative anesthetic agent commonly used for short surgical procedures which has the properties of rapid induction, good analgesia, and amnesia with a short recovery period. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |