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  Table of Contents 
Year : 2021  |  Volume : 22  |  Issue : 1  |  Page : 97

Response to “MOKA ICE-CUBES: A novel mixture for paediatric oral premedication”

Department of Anaesthesiology, AIIMS, Raipur, Chhattisgarh, India

Date of Submission31-Jul-2020
Date of Acceptance28-Oct-2020
Date of Web Publication22-Feb-2021

Correspondence Address:
Dr. Tuhin Mistry
G-304, Jainam Planet, Tatibandh, Raipur - 492 099, Chhattisgarh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/TheIAForum.TheIAForum_123_20

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How to cite this article:
Poonuraparampil JA, Mistry T. Response to “MOKA ICE-CUBES: A novel mixture for paediatric oral premedication”. Indian Anaesth Forum 2021;22:97

How to cite this URL:
Poonuraparampil JA, Mistry T. Response to “MOKA ICE-CUBES: A novel mixture for paediatric oral premedication”. Indian Anaesth Forum [serial online] 2021 [cited 2021 May 9];22:97. Available from: http://www.theiaforum.org/text.asp?2021/22/1/97/309744


With interest, we read the recently published letter on “MOKA ICE-CUBES: A novel mixture for paediatric oral premedication”.[1] We would like to congratulate the authors and appreciate them for sharing their research work. However, we have the following concerns:

  1. It is not clear if informed assent was obtained from the children aged 7–15 years along with the consent of parents or legally authorized representative[2]
  2. According to authors, four drugs were mixed with apple juice or coconut water and then ice cubes were prepared. The chemical stability of the final solution and the interaction among constituents is unknown. The possibility of formation of microprecipitates may affect the function of one or more components
  3. The weight range makes appropriate dosing of ondansetron difficult. Hence, almost twice the required dose has been administered
  4. The sterility and safety of the ice cubes are a matter of concern
  5. The ice cubes may precipitate bronchial asthma, especially in susceptible children with hyperreactive airway.[3] Moreover, ice cubes may not be accepted by children and their parents during the winter season
  6. Triclofos syrup is relatively cheaper, safe, widely used, and readily available alternative.[4]

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Conflicts of interest

There are no conflicts of interest.

  References Top

Chokshi T, Gupta B. “MOKA ICE-CUBES”: A novel mixture for paediatric oral premedication. Indian Anaesth Forum 2020;21:166-8.  Back to cited text no. 1
  [Full text]  
Mathur R. National ethical guidelines for biomedical and health research involving human participants. New Delhi: Indian Council of Medical Research; 2017. Available from: https://ethics.ncdirindia.org//asset/pdf/ICMR_National_Ethical_Guidelines.pdf. [Last accessed on 2020 Jul 31].  Back to cited text no. 2
National Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 2007 August. Available from: https://www.ncbi.nlm.nih.gov/books/NBK7232/.  Back to cited text no. 3
Gupta A, Gunjan , Shekhar S, Gupta S, Gupta A. Comparison of oral triclofos and oral midazolam as premedication in children undergoing elective surgery. Anesth Essays Res 2019;13:366-9.  Back to cited text no. 4
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