Oral ketamine premedication can prevent emergence agitation in children after desflurane anaesthesia

Paediatr Anaesth. 2004 Jun;14(6):477-82. doi: 10.1111/j.1460-9592.2004.01224.x.


Background: The purpose of the present study was to determine whether oral ketamine premedication affected the incidence of emergence agitation in children.

Methods: Thirty minutes before induction of anaesthesia, 80 children who were undergoing adenotonsillectomy with or without bilateral myringotomy and insertion of tubes received either ketamine 6 mg.kg(-1) per oral in group K or sour cherry juice alone in group C. Anaesthesia was maintained with desflurane. Emergence and recovery times were recorded. Tramadol was used for postoperative analgesia. Fentanyl (1 microg.kg(-1)) was administered for the treatment of emergence agitation or severe pain that still continued after tramadol administration. Postoperative behaviour was evaluated using a 5-point agitation scale.

Results: The incidence of emergence agitation was 56% in group C, and 18% in group K (P = 0.001). There was no significant difference with respect to emergence times except from time to eye opening that was significantly longer in group K (P < 0.0001).

Conclusion: Oral ketamine premedication reduced the incidence of postanaesthesia emergence agitation in children without delaying recovery.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adenoidectomy
  • Administration, Oral
  • Analgesics, Opioid / therapeutic use
  • Anesthesia Recovery Period*
  • Anesthetics, Inhalation* / adverse effects
  • Child
  • Child, Preschool
  • Desflurane
  • Double-Blind Method
  • Female
  • Humans
  • Isoflurane* / adverse effects
  • Isoflurane* / analogs & derivatives*
  • Ketamine / administration & dosage*
  • Male
  • Pain, Postoperative / drug therapy
  • Preanesthetic Medication*
  • Psychomotor Agitation / etiology
  • Psychomotor Agitation / prevention & control*
  • Tonsillectomy
  • Tramadol / therapeutic use


  • Analgesics, Opioid
  • Anesthetics, Inhalation
  • Tramadol
  • Ketamine
  • Desflurane
  • Isoflurane