Abstract

FORMULATION AND CLINICAL EVALUATION OF ORAL AND RECTAL TRANSMUCOSAL KETAMINE AS PREMEDICATION IN CHILDREN

Abstract

Fear of hospitals (operations, diagnosis and injections) where the children are separated from their parents prior to anesthesia and during CT-Scan is very common. ketamine hydrochloride (KH) was widely used as a preanaesthetic medication by intravenous and intramuscular injection. So, this study is an attempt to produce another alternative method as preanesthesia. This study is designed to formulate and evaluate the clinical efficacy and safety of ketamine as lozenges and suppositories via oral and rectal transmucosal ketamine as premedication in children. Ketamine was formulated as a lozenges (100 mg / 5 gm) and rectal suppositories (100 mg/ gm of base) in different bases such as coca butter, glycerinated gelatin, and polyethylene glycol. Double blind, randomized, comparative study of 22 healthy children, aged 2 to 6 years, weighed 9 to 24 kg were carried out ; in Radiation department, Al-Sabain Hospital (Sana'a city) for prediagnostic procedures (CT scan). The children were classified into two groups: Group A (Twelve children) : were premedicated with ketamine as lozenges orally ( 4 mg/kg). Group B (Ten children) : were premedicated with ketamine rectally (5 mg/kg). Rectal ketamine gave more satisfactory results than the oral ketamine which was 90% and 83.4% respectively in case of separation from parents, 90% and 75% respectively in case of placing on CT scan instrument with less complications.

Keywords: KH (Ketamine HCL) , Paediatric anaesthesia, Premedication, , Suppositories. ASA (American society of anesthesiologists) , D.W (distilled water)