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PubMed1991

A novel approach to anxiolytic premedication for day-case patients.

The usefulness of 10 mg timolol orally as a non-sedative anxiolytic premedicant for day-case patients was examined in a double-blind placebo-controlled study. Patients were invited to take part by letter sent the week before gynaecological (n = 40) or oral (n = 60) surgery was scheduled. Indices of anxiety and alertness were obtained prior to administration of the tablet; quality of previous anaesthetic experience was also recorded. In those patients with no previous or unpleasant previous anaesthetic experience a significant reduction in anxiety amongst those given timolol was identified. Haemodynamic differences between the groups were not clinically significant, and return of psychomotor function was not delayed by timolol. Timolol effectively reduces situational anxiety, is non-sedative, and is advocated as a premedicant for anxious day-case patients and others in whom rapid return of psychomotor function is desirable.

Adolescent↗
PubMed1990

Oral premedication in children: a comparison of chloral hydrate, diazepam, alprazolam, midazolam and placebo for day surgery.

A double-blind study consisting of 339 randomly selected children investigated the effects of several premedicants on the preoperative and postoperative behaviour of children who underwent day-stay surgery. Patients were allocated into two groups. Group 1 consisted of 165 children aged between 6 and 47 months. Group 2 consisted of 174 children aged four years and older to a body weight of 50 kg. Each child received one premedicant. Both groups included alprazolam 0.005 mg/kg, midazolam 0.3 mg/kg and placebo. In addition Group 1 included chloral hydrate 40 mg/kg and Group 2 diazepam 0.25 mg/kg. Chloral hydrate produced superior conditions (more patients calm or asleep) at induction of anaesthesia. Postoperative behaviour and incidence of vomiting were similar for all drugs. No premedicant reduced anxiety in the older group. The time to awaken postoperatively with diazepam was longer than with placebo. Alprazolam and midazolam were unpalatable for children over four years and conferred no advantage over placebo.

Administration, Oral↗
PubMed1997

Comparison of the efficacy of paracetamol versus paracetamol, codeine and promethazine (Painstop) for premedication and analgesia for myringotomy in children.

This prospective double-blinded study compared the analgesic effectiveness and incidence of complications of a compound preparation Painstop (Paedpharm Pty Ltd) containing paracetamol 12 mg, codeine 0.5 mg and promethazine 0.65 mg per 1.0 ml, dosage 1.0 ml/kg, with paracetamol 20 mg/kg. Ninety-five children aged 1 to 12 years, ASA 1-2, scheduled for myringotomy and drain tuber insertion as a day procedure were randomized to receive Painstop or paracetamol 30 to 60 minutes prior to surgery. Preoperative drowsiness and complications on induction and postoperative sedation, pain and times to achieve goals were recorded. The groups were comparable for age, gender, weight, anaesthetic technique and duration of surgery. Times to eye opening (P = 0.05) and first oral intake (P = 0.006) were significantly longer in the Painstop group. There was, however, no difference in times to discharge. Late sedation was more common in the Painstop group (P = 0.03). Pain scores were low and similar in both groups and the need for additional analgesia was uncommon.

Acetaminophen↗
PubMedDate not supplied

Intramuscular lorazepam versus pentobarbital premedication: a comparison of patient sedation, anxiolysis, and recall.

In a double-blind, controlled study in 40 veterans, IM lorazepam was significantly superior to IM pentobarbital as a preoperative sedative and in ability to suppress the memory of events of the operative day. A trend was noted (not statistically in this small series) toward greater patient acceptance of lorazepam. No important adverse effects or changes in vital signs occurred with either agent.

Adult↗
PubMedDate not supplied

A comparison of droperidol, diazepam, and hydroxyzine hydrochloride as premedication.

A double-blind comparison of the efficacy and safety of droperidol (5 mg), hydroxyzine HCl (50 mg), diazepam (5 mg), and saline placebo, given concomitantly with meperidine (50 or 75 mg) for preoperative medication, was conducted in 280 female patients scheduled for minor gynecologic procedures. Droperidol proved to significantly superior to the other study drugs in alleviating apprehension (83% of patients calm versus 54, 46, and 34% for hydroxyzine, diazepam, and placebo, respectively). Some drowsiness, occurred in 68 percent of the droperidol-treated patients versus 31, 30, and 21 percent of the other 3 groups, respectively. Global evaluations were consistent with these findings. No clinically significant changes were observed in vital signs in any of the study-drug groups. Adverse reactions were unremarkable in all groups. Significantly less nausea occurred with droperidol than with other treatments, and signficantly less vomiting occurred with droperidol or hydroxyzine. Significantly fewer patients in the droperidol group than in the diazepam group required postoperative antiemetics.

Adolescent↗
PubMedDate not supplied

RO 21-3981 for intravenous surgical premedication and induction of anesthesia.

RO 21-3981, a new water soluble benzodiazepine, was studied in 24 patients both as an intravenous premedicant and to induce anesthesia. The premedicant dose of 5 mg produced lack of recall and marked sedation within 1 to 2 minutes after injection and persisted for at least 32 minutes. Subsequent induction of anesthesia required an additional 5 to 25 mg of RO 21-3981. However, anesthesia was not induced in 1 patient with 25 mg and was accomplished only with inhalation anesthesia. Loss of lid reflex was unreliable as a sign of induction for patients in whom tracheal intubation was planned. Although decreases in blood pressure of 10 to 30 mm Hg were noted after administration of RO 21-3981, systolic pressure was not recorded below 90 mm Hg. RO 21-3981, because of its amnesic, sedative, and anxiolytic properties, appears to be an excellent premedicant although the 5 mg dose studied was probably larger than necessary. For induction of anesthesia, RO 21-3981 may be an effective alternative to thiopental.

Adult↗
PubMed2005

The minimum infusion rate (MIR) of propofol for total intravenous anesthesia after premedication with xylazine in horses.

To investigate an adequate infusion rate of propofol for total intravenous anesthesia (TIVA) in horses, the minimum infusion rate (MIR) comparable to the minimum alveolar anesthetic concentration (MAC) of inhalation anesthetic was determined under constant ventilation condition by intermittent positive pressure ventilation (IPPV). In addition, arterial propofol concentration was measured to determine the concentration corresponding to the MIR (concentration preventing reaction to stimulus in 50% of population, Cp(50)). Further, 95% effective dose (ED(95)) was estimated as infusion rate for acquiring adequate anesthetic depth. Anesthetic depth was judged by the gross purposeful movement response to painful stimulus. MIR and Cp(50) were 0.10 +/- 0.02 mg/kg/min and 5.3 +/- 1.4 microg/ml, respectively. ED(95) was estimated as 0.14 mg/kg/min (1.4MIR).

Analysis of Variance↗
PubMed2002

A comparative evaluation of oral midazolam with other sedatives as premedication in pediatric dentistry.

The purpose of present study was to evaluate the safety and efficacy of orally administered midazolam in children as a sedative agent and to compare it with two other older agents, triclofos and promethazine. The study was conducted on ninety child patients requiring some short dental procedure. All the patients were with a good physical status (ASA-I). The ages ranged between 3 and 9 years. The patients were randomized into three study groups: Group 1, midazolam, Group II, triclofos and Group III, promethazine, on the basis of the drugs to be administered. After administration of drugs in each group, the effects were evaluated in terms of onset of action, sedative effect, ease of treatment completion, recovery time and postoperative amnesia. Midazolam was found to be the best drug among the three to produce conscious sedation in children.

Administration, Oral↗

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