الفهرس 
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Abstract
This study was carried out in the Alexandria University hospitals on 30 pediatric patients undergoing minor surgical procedure.
The patients were grouped into two equal groups each group included 15 patients:
Group I : They received Ketamine hydrochloride orally in a dose of 6mg/kg body weight mixed with 0.2 ml /kg body weight of orange flavored Soft drink.
Group II: They received Ketamine hydrochloride orally in a dose of 6mg/kg body weight mixed with 0.2 ml /kg body weight of orange flavored Soft drink and Diazepam orally in a dose of 0.25 mg/kg body weight
There were non-significant differences between the two groups as regards ages and weights.
Evaluation of the patients was carried out through proper history taking, through clinical examination and routine laboratory investigations.
The following parameters were recorded :
1- Vital signs: Heart rate, arterial blood pressure (systolic , diastolic and mean blood pressure ), respiratory rate .All were measured before the administration of premedication,15min after the premedication,30 min after the premedication, before induction of anaesthesia,10 min after the start of surgery, 20 min after the start of surgery , at the recovery room and 10min after the recovery.
2- Acceptance of the child to the oral premedicant.
3- Vomiting
4- Onset of sedation.
5- Time of maximal sedation.
6- State of sedation.
7- Emotional state.
8- Attitude of the patient.
9- Airway obstruction.
10- Nystagmus.
11- Random limb movement.
12- Tongue fasciculation.
13- Convulsions.
14- Laryngospasm.
15- Secretion scale.
The results can be summarized as the following:
There were no statistically significant changes in the haemodynamics throughout the study period in each group and in comparing both studied groups together. This stability of haemodynamics was due to absent effect of both ketamine and diazepam in the oral form of administration as well as with this small doses of the both drugs. In the present study, an insignificant change in the mean value of the respiratory rate as compared to the mean value of the respiratory rate in the pre-operative period observed in both groups. Also the difference between the both groups was statistically insignificant. There was no obvious clinical evidence of respiratory depression following premedication with oral ketamine or oral ketamine with oral diazepam.
In this study, it was found that there was statistically significant difference between both groups as regards the onset of sedation. Group I: had a mean onset of sedation (13±3.162) minutes while Group II : had a mean onset of sedation (10.66±4.16) minutes This means that diazepam was effective in sedating the children and fastening the effect of oral ketamine.
There was statistically significant difference between both groups as regards the time of maximal sedation. Group I : had a mean of maximal sedation (26±3.3) minutes while Group II : had a mean of maximal sedation (19.66±4.6) minutes The possible explanation is that diazepam was well absorbed from the GIT with a rapid onset of action and reaches its maximal sedation effect also rapidly.
In this study as regards the state of sedation, It was found that there was significant difference could be elicited between the both groups. This is because oral diazepam increased the sedative effect of oral ketamine.
In this study as regards the emotional state, It was found that there was significant difference could be elicited between the both groups. This means that oral diazepam increased the anxiolytic effect of oral ketamine.
In this study as regards the attitude scale, The difference between both groups were statistically significant. An possible explanation is that oral diazepam in this dose showed good anxiolytic effect of short duration.
In this study as regards the response to the insertion of the catheter The difference between both groups was statistically significant due to the anxiolytic effect of the diazepam.
In this study as regards the sedation state, the emotional state and the attitude of the child, it was found that: The difference between both groups were statistically significant after 30 of the premedication and upon arrival to the operative room while the difference between both groups were statistically insignificant at the recovery room. A possible explanation is that oral diazepam in this dose has a anxiolytic good effect of a short duration so its effect did not appeared at the recovery room.
In the post-operative period, the incidence of vomiting in children in both groups were statistically insignificant.
In the present study minor complication were detected among the studied groups.