摘要：

Background: Because of its pain-attenuating and sedative prop-erties oral ketamine has been used as premedication in children and adults. We wanted to compare in children scheduled for adenoidectomy safety and efficacy of oral ketamine with a pre-medication that causes similar preoperative sedation and relief of pain at the venepuncture site. We also evaluated the effect of i.v. glycopyrrolate added to these combinations. Methods: One hundred children between 10 and 15 kg of body weight scheduled for day-case adenoidectomy were randomly assigned to one of four groups: groups DG and DS received diclofenac 12.5 mg and diazepam 0.5 mg/kg rectally, EMLA A cream at the venepuncture site, and placebo orally; groups KG and KS received ketamine 6.0 mg/kg orally, placebo cream at the puncture site, and placebo rectally; additionally, groups DG and KG received glycopyrrolate 5 mg/kg, and groups DS and KS received placebo intravenously. We recorded perioperatively scores (open scale 1--9) for stridor, sedation, bleeding, nausea, pain, heart rate, the need for analgesics and registered psychoto-mimesis and well-being at home. Results: The children of the K-groups became more tearful dur-ing separation from their parents (P--0.0072). No other differ-ences were found between the ketamine and diazepam/diclo-B.

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