The International Tinnitus Journal

Comparison of Sedation Effect between Midazolam Nebulization and Midazolam - Ketamine Nebulization in Pediatric Ophthalmic Surgery

Author(s): Abbas Ostadalipour, Asgar Hajipour*, Afzal Shamsi, Abbas Rahimiforoushani, Mukhalled Mahdi Saleh, Maryam Jamshidi, Maziar Maghsoudlo, Ebrahim Espahbodi, Ghada Ibrahim Ali

Background: Pre-anaesthetic drugs are regularly given to children as pharmacological adjuncts to help reduce anxiety and stress before surgery, as well as to soothe separation anxiety from the child's parents and facilitate a smooth induction. Prescription drugs like ketamine and midazolam may be used to sedate children before surgery. Objectives: The aim of this study is comparison of sedation effect between midazolam nebulization and Midazolam- ketamine nebulization in pediatric ophthalmic surgery farabi eyes hospital in Tehran: A Clinical Trials. Methods: A total of 50 children, that is, 25 in two groups, underwent the study at Farabi Ophthalmic Hospital during August–October of 2023. Prior, the nebulization standard monitoring (HR, SBP, and SPO2) was instituted in both groups in setting position. Patients in group M received midazolam inhalation 0.5 mg/kg in 3 cc of distilled water. Group MK received 0.5 mg/kg midazolam and 2 mg/kg ketamin diluted with 2 ml of distilled water. All patients were assessed before receiving the drug and reassessed 15 minutes after nebulization, and (HR, SBP, SPO2), the Ramsay sedation scale, the Parent Separation Anxiety Scale (PSAS), and face mask acceptance were recorded. Results: The results demonstrated that there are no significant differences in demographic characteristics such as age, sex, and weight between the groups of midazolam and midazolam ketamin. There were no significant statistical differences between the midazolam and midazolam ketamin groups in SPO2 (P-value = 0.735), HR (P-value =0.526), and SBP (P-value =0.644). Furthermore, the Ramsay Sedation Scale in the midazolam ketamine group was significantly higher than the other group of midazolam (P-value = 0.033). Regarding mask acceptance, the study group had a higher significant relationship with midazolam ketamin when compared to the midazolam group (P-value < 0.001). There was a significant relationship between the study group and parent separation, as the midazolam ketamine group was significantly higher than the group of midazolam (P-value = 0.018). Conclusions: Overall, our findings suggest that nebulized midazolam-ketamine is a safer and more effective sedative than nebulized midazolam as a nebulizer premedication for patients in pediatrics eye surgery requiring general anesthesia.

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