Comparing the Sedative Effect of Oral Midazolam versus Oral Ketamine on Children Aged 1-7 Years in Need of Radiologic Procedures

Abstract

Sedation is one of the most important criteria for eliciting the cooperation of young patients. The purpose of this study was to compare the sedative effect of oral administration of ketamine and midazolam in children admitted to an emergency department in Zahedan. In this double-blind clinical trial, children were placed in grades one and two according to the ASA status classification system. Then, they were randomized into two groups of 50 individuals each. One group received 0.5mg/kg midazolam and the other received 5 mg/kg ketamine. The medication was administered orally in both groups. The scores of children’s sedation and separation from their parents were recorded, and the obtained data were analyzed in SPSS using Chi-square test and independent t-test. The mean heart rate of patients before the intervention in the two groups had a slight difference, which was not statistically significant (P = 0.159). But after the intervention, this mean was significantly different in the two groups (P = 0.018). The mean scores of sedations and separation from the parent were not significantly different at 10, 20, and 30 minutes after medication in the two groups before and after the intervention. The mean length of hospitalization after sedation in the two groups differed significantly (p = 0.007) in the ketamine group (28.62 minutes) and the midazolam group (34.04 minutes). In the ketamine group, the mean heart rate decreased less after the intervention and the length of hospital stay was shorter compared with the midazolam group. Also, the percentage of children who showed earlier onset of sedation (20 minutes after taking the drug) was higher [in the ketamine group]. Therefore, ketamine seems more desirable for treatment and radiographic procedures in the emergency department.