Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Premedication”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources
PubMed1996

Pharmacological premedication for anaesthesia.

The psychological component of preoperative preparation should be completed with a selective use of drugs. The days of poly-pharmacy are over. Heavily sedated patients coming to the operation room with minimal oral secretions are not the purpose of modern premedication. Anxiolysis and slight sedation (painless patients) and analgesia (patients suffering from pain) are the main goals. Anticholinergics should be used only when needed, as is the case with premedication generally. The use of antiemetics and that of agents given for prophylaxis against allergic reactions or aspiration pneumonitis depend on specific needs of the patient. More accurate and generally accepted but simple methods are needed in studying the effects of different premedicants. The present results produced with a huge number of different more or less validated assessments can seldom be compared with each other.

Procedural Sedation↗
PubMed1996

Oral midazolam premedication for paediatric day case patients.

Forty-nine children having day-stay surgical procedures were randomly assigned to receive oral midazolam 0.75 mg.kg-1 or placebo in a double blind fashion. The child's level of anxiety was assessed before premedication using parental, child and observer scales. The child and observer anxiety scores were repeated in the anaesthetic room. Most children presented for anaesthesia in a calm state, irrespective of whether they had received midazolam. Parents tended to overestimate their child's level of anxiety. Observer anxiety scores reliably predicted behaviour during induction of anaesthesia in the absence of a sedative. Observer scores decreased in the midazolam group (P < 0.02), but not in the placebo group, children below six years having the greatest decrease with midazolam. The median time to discharge from hospital was delayed by 30 min in the midazolam group (P < 0.01). Children do not require routine sedative premedication for day case procedures, but oral midazolam is useful in producing calm behaviour in those children with high observer anxiety scores.

Administration, Oral↗
PubMed2004

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

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.

Adenoidectomy↗
PubMed2005

Preliminary experience with oral dexmedetomidine for procedural and anesthetic premedication.

BACKGROUND: Oral premedication is often required in children to provide anxiolysis and lessen the psychological impact of hospitalization and/or procedures. We present our experience with dexmedetomidine as an oral premedicant prior to procedural sedation or anesthetic induction. METHODS: We undertook a retrospective review of the anesthesia or sedation service records of patients who received oral dexmedetomidine. RESULTS: The cohort for the study included 13 patients ranging in age from 4 to 14 years. Oral dexmedetomidine (mean dose: 2.6 +/- 0.83 microg.kg(-1); range 1.0-4.2 microg.kg(-1)) was used as premedication prior to anesthesia induction in four patients and prior to intravenous (IV) cannula placement for procedural sedation in nine patients with neurobehavioral problems. Effective sedation was achieved in 11 of 13 patients. The one patient in whom anxiolysis was not achieved received the lowest dose of dexmedetomidine (1 microg.kg(-1)) prior to anesthesia induction. In the other three patients, parental separation and acceptance of the mask was achieved at 20-30 min with a dose of 2.5 microg.kg(-1). When used for procedural sedation, placement of an IV cannula was accomplished without difficulty in seven of eight patients with neurobehavioral disorders and with only mild resistance in the other. No complications were noted and parental satisfaction with the sedation experience was high. CONCLUSIONS: These preliminary data suggest that dexmedetomidine may be an effective oral premedicant prior to anesthesia induction or procedural sedation. We found that it was effective even in patients with neurobehavioral disorders in whom previous attempts at sedation had failed.

Administration, Oral↗
PubMed2006

Oral clonidine premedication reduces minimum alveolar concentration of sevoflurane for laryngeal mask airway insertion in children.

BACKGROUND: Sevoflurane is widely employed for inhalational induction in children. Clonidine deepens volatile anesthetics and reduces several types of MAC of sevoflurane. Laryngeal mask airway is a useful device for pediatric anesthesia. The aim of the current study was to determine whether oral clonidine premedication can reduce MAC of sevoflurane for an LMA insertion in children. METHODS: Fifty-six ASA physical status I patients (3-11 years) scheduled for general anesthesia were randomly divided into two groups of 28 patients each. One group (clonidine group) received clonidine 4 microg x kg(-1) approximately 100 min before anesthesia, and the other (control) group did not. Anesthesia was induced with sevoflurane. Each concentration of sevoflurane, at which an LMA insertion was attempted, was predetermined according to the modification of Dixon's up-and-down method with 0.25% as a step size and held constant for at least 20 min before the trial. All responses ('movement' or 'no movement') to an LMA insertion were assessed. RESULTS: Minimum alveolar concentration values of sevoflurane for an LMA insertion were lower in the clonidine group (1.31% +/- 0.18% [mean +/- sd]) than in the control group (2.00% +/- 0.16%). Logistic regression analysis revealed that sevoflurane EC95 values were 1.79% and 2.49% in the clonidine and control groups, respectively. CONCLUSIONS: Oral clonidine premedication reduced the MAC (EC50) and EC95 values of sevoflurane for LMA insertion by 38% and 28%, respectively.

Administration, Oral↗
PubMed1993

Xylazine or medetomidine premedication before propofol anaesthesia.

The duration of action and cardiopulmonary effects of propofol (6.55 mg/kg intravenously), xylazine (0.8 mg/kg intramuscularly), medetomidine (30 micrograms/kg intramuscularly), xylazine plus propofol (3 mg/kg intravenously) and medetomidine plus propofol (3 mg/kg intravenously) were compared in dogs. A cannula inserted into a raised carotid artery before the drugs were given allowed the continuous recording of blood pressure and heart rate and the measurement of arterial pH, PCO2, PO2, bicarbonate and base balance. Xylazine and medetomidine premedication prolonged propofol anaesthesia in dogs. Propofol alone reduced blood pressure and transiently raised heart rate. The apnoea and hypoxaemia induced by propofol alone also occurred in the premedicated groups with hypoxaemia being most evident in the medetomidine/propofol group. Bradycardia was a common feature in all the dogs given xylazine or medetomidine, but hypertension was consistently recorded in all the dogs given medetomidine.

Acid-Base Equilibrium↗
PubMed1990

Oral ketamine premedication for paediatric cardiac surgery--a comparison with intramuscular morphine (both after oral trimeprazine).

In a single-blind controlled study, forty children with congenital heart disease were premedicated with oral trimeprazine 3 mg/kg and either intramuscular morphine 0.1 mg/kg or oral ketamine 10 mg/kg. Cardiovascular and respiratory effects of premedication and degree of sedation induced were similar in the two groups of patients. Oral ketamine is a safe and effective premedicant in this group of patients.

Administration, Oral↗
PubMed1993

A dose-response study of orally administered clonidine as premedication in the elderly: evaluating hemodynamic safety.

Clonidine premedication in a dose of 5 micrograms/kg may be particularly well suited for elderly patients. To pursue this approach, sedation, intraocular pressure (IOP), and the hemodynamic profile of two doses of oral clonidine premedication were compared in 60 elderly patients, aged 65-82 yr, who underwent elective ophthalmic surgery under local anesthesia. Group 1 (n = 20) received placebo, Group 2 (n = 20) 150 micrograms of clonidine (2-2.5 micrograms/kg), and Group 3 (n = 20) 300 micrograms of clonidine (4-4.5 micrograms/kg) in a randomized, double-blind fashion. Decreases in mean arterial blood pressure were more pronounced and occurred earlier after 300 micrograms of clonidine (31.4 +/- 12.1%, P < 0.001) as compared to 150 micrograms of clonidine (18.1 +/- 10.9%, P < 0.001). Throughout the study, six patients (30%) in Group 3 (300 micrograms clonidine-treated group), but no patient in Groups 1 or 2, were treated at least once for hypotension (P < 0.05). Heart rate decreased significantly 18.5 +/- 8.1% (P < 0.001) only after 300 micrograms of clonidine. Clonidine 150 micrograms and 300 micrograms decreased IOP 32.1 +/- 14.3% (P < 0.001) and 47.8 +/- 17.2% (P < 0.001), respectively. After 150 micrograms of clonidine patients were significantly more sedated as compared to those given placebo (P < 0.01) but significantly less sedated than after 300 micrograms of clonidine (P < 0.01), where sedation persisted more than 6 h postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed2005

Acute hypersensitivity reaction to ferric gluconate in a premedicated patient.

OBJECTIVE: To report a case of an acute hypersensitivity reaction to ferric gluconate in a patient premedicated with dexamethasone, diphenhydramine, and prochlorperazine. CASE SUMMARY: A 38-year-old female with persistent iron deficiency anemia was initiated on parenteral iron therapy with ferric gluconate 125 mg intravenously over 10 minutes. The patient initially tolerated this first dose well; however, she later experienced nausea, dizziness, and minor tongue swelling. On her second course of therapy, the woman was premedicated with dexamethasone, diphenhydramine, and prochlorperazine prior to the same dose of ferric gluconate infused over 30 minutes. Subsequently, the patient developed epigastric pain, nausea, swelling of her lips and tongue, and hypotension. The symptoms abated after administration of diphenhydramine, dexamethasone, morphine, cimetidine, intravenous fluids, and oxygen. She was discharged after a short stay in the emergency department observation unit. DISCUSSION: Data are limited on the relative safety of ferric gluconate compared with iron dextran. Ferric gluconate does not appear to be associated with severe life-threatening events; however, the possibility of an acute hypersensitivity reaction with this product does exist. In this case, use of the Naranjo probability scale indicated a probable relationship between the hypersensitivity reaction and ferric gluconate. CONCLUSIONS: Healthcare professionals should be aware of this serious but rare event and encouraged to further document and report these events.

Adult↗
PubMed2006

Premedication for nonemergent neonatal intubations: a randomized, controlled trial comparing atropine and fentanyl to atropine, fentanyl, and mivacurium.

OBJECTIVE: The purpose of this work was to investigate whether using a muscle relaxant would improve intubation conditions in infants, thereby decreasing the incidence and duration of hypoxia and time and number of attempts needed to successfully complete the intubation procedure. PATIENTS/METHODS: This was a prospective, randomized, controlled, 2-center trial. Infants requiring nonemergent intubation were randomly assigned to receive atropine and fentanyl or atropine, fentanyl, and mivacurium before intubation. Incidence and duration of hypoxia were determined at oxygen saturation thresholds of < or = 85%, < or = 75%, < or = 60%, and < or = 40%. Videotape was reviewed to determine the time and number of intubation attempts and duration of action of mivacurium. RESULTS: Analysis of 41 infants showed that incidence of oxygen saturation < or = 60% of any duration was significantly less in the mivacurium group (55% vs 24%). The incidence of saturation level of any duration < or = 85%, 75%, and 40%; cumulative time > or = 30 seconds; and time below the thresholds were not significantly different. Total procedure time (472 vs 144 seconds) and total laryngoscope time (148 vs 61 seconds) were shorter in the mivacurium group. Successful intubation was achieved in < or = 2 attempts significantly more often in the mivacurium group (35% vs 71%). CONCLUSIONS: Premedication with atropine, fentanyl, and mivacurium compared with atropine and fentanyl without a muscle relaxant decreases the time and number of attempts needed to successfully intubate while significantly reducing the incidence of severe desaturation. Premedication including a short-acting muscle relaxant should be considered for all nonemergent intubations in the NICU.

Adjuvants, Anesthesia↗
PubMed2005

Improvement of image quality with beta-blocker premedication on ECG-gated 16-MDCT coronary angiography.

OBJECTIVE: The objective of our study was to assess the effect of beta-blockers on image quality of ECG-gated 16-MDCT coronary angiography. MATERIALS AND METHODS: Coronary CT angiography was performed in two groups: group 1, 24 volunteers (mean age, 50 years; mean heart rate, 69 beats per minute [bpm]; range, 47-97 bpm); and group 2, 15 patients with current ischemic heart disease (mean age, 54 years; mean heart rate, 54 bpm; range, 48-69 bpm) who were premedicated with 20-40 mg of oral propranolol 1 hr before the study. CT scans were obtained on a 16-MDCT scanner with a 12 x 0.75 mm collimation and 420-msec rotation using nonionic contrast material (80 mL; injection rate, 4 ml/sec). Images were reconstructed at 30-80% of the cardiac cycle in increments of 5%. Image quality of the following eight coronary segments was assessed by two radiologists in consensus: left main coronary artery; proximal and middle segments of the left anterior descending (LAD) and left circumflex (LCX) coronary arteries; and the proximal, middle, and distal segments of the right coronary artery (RCA). Image quality was assessed, using a 5-point grading scale, as grades 1-5. Images assessed as grade 4 or 5 were considered to be of diagnostically acceptable quality. RESULTS: In group 1, grade 4 or 5 image quality was achieved for visualization of 92% of the left main coronary arteries; 96% of the proximal LAD coronary arteries; 88% of the middle LAD, proximal LCX, and middle LCX coronary arteries; 83% of the proximal RCAs; 58% of the middle RCAs; and 96% of the distal RCAs. In group 2, this level of image quality was achieved in 100% of the left main coronary arteries, proximal and middle LAD arteries, and proximal LCX arteries; 87% of the middle LCX arteries; and 93% of the proximal, middle, and distal RCAs. CONCLUSION: Reduction of heart rates with beta-blocker premedication improves the image quality of CT coronary angiography, especially in terms of the visualization of the right coronary artery.

Adrenergic beta-Antagonists↗
PubMed2001

Some cardiopulmonary effects of midazolam premedication in clenbuterol-treated bitches during surgical endoscopic examination of the uterus and ovariohysterectomy.

Midazolam was administered intravenously to 8 bitches in a randomised, placebo-controlled clinical trial before propofol induction of surgical anaesthesia. Anaesthesia was maintained with isoflurane-in-oxygen during surgical endoscopic examination of the uterus and ovariohysterectomy. Clenbuterol was administered at the start of surgery to improve uterine muscle relaxation, and to facilitate endoscopic examination of the uterus. Ventilation was controlled. Induction of anaesthesia with propofol to obtain loss of the pedal reflex resulted in a statistically significant (P < 0.05) decrease in minute volume and arterial oxygen partial pressure in the midazolam group. Apnoea also occurred in 50% of dogs in the midazolam group. The dose for propofol in the midazolam group was 7.4 mg/kg compared to 9.5 mg/kg in the control. Minute volume was significantly (P < 0.05) higher in both groups during isoflurane maintenance, compared to the value after incremental propofol to obtain loss of the pedal reflex. Propofol induction resulted in a 25-26% reduction in the mean arterial blood pressure in both groups, and the administration of clenbuterol at the start of surgery resulted in a transient, but statistically significant (P < 0.05), decrease in mean arterial blood pressure in the midazolam group during isoflurane anaesthesia. It is concluded that intravenous midazolam premedication did not adversely affect cardiovascular function during propofol induction, but intra-operative clenbuterol during isoflurane maintenance of anaesthesia may result in transient hypotension. Midazolam premedication may increase adverse respiratory effects when administered before propofol induction of anaesthesia.

Adjuvants, Anesthesia↗
PubMed1999

The effect of midazolam premedication on mental and psychomotor recovery in geriatric patients undergoing brief surgical procedures.

UNLABELLED: To assess the effect of IV midazolam premedication on recovery of cognitive function, 90 geriatric patients (aged 65-81 yr) undergoing brief transurethral procedures were enrolled into this prospective, placebo-controlled, double-blinded study. In all cases, a standard general anesthetic was administered. Thirty minutes before operating room transfer, patients in Group 0.5 mg, Group 2 mg, and Group S received 0.5 mg of midazolam, 2 mg of midazolam, or an equal volume of saline, respectively. Before study-drug administration (baseline), at 15 min thereafter, as well as on arrival in the postanesthesia care unit (PACU), and at 60 min and 120 min, postoperatively, we administered a digit-symbol substitution test, a mini-mental test, a shape-sorter test, and a patient-generated 100-mm visual analog score (0 = minimal and 100 = maximal) for anxiety, sleepiness, and coordination. A 4-point scale was used to assess the degree of patient sedation at 7, 15, and 30 min after study-drug administration. Using a modified Aldrete scoring system, PACU discharge was determined by the PACU staff. Patient anxiety, sleepiness, and coordination scores at baseline and at 15 min after study-drug administration were similar. When compared with saline, midazolam was associated with a significantly (P < 0.05) higher incidence of "deep" sedation. In Group 2 mg, the incidence of a low preoperative Spo2 (<94%) was significantly (P < 0.05) higher when compared with Group S. Emergence, extubation, and orientation times, as well as time to follow commands were unaffected by midazolam premedication. Postoperatively, the digit-symbol substitution test, mini-mental test, and shape-sorter test were similar among the groups. However, time to PACU discharge was significantly (P = 0.03) longer in the two midazolam treatment groups (41 +/-25 min, 60 +/- 32 min, 53 +/- 39 min for Groups S, 0.5 mg, and 2 mg, respectively). Finally, patient satisfaction was unaffected by the randomization schedule. IMPLICATIONS: IV premedicant midazolam 0.5 mg or 2 mg does not adversely affect mental and psychomotor recovery in geriatric patients undergoing brief surgical procedures. However, midazolam administration significantly prolonged postanesthesia care unit discharge time. Finally, during the preoperative period, midazolam increases the incidence of a Spo2 <94% in a dose-dependent manner.

Aged↗
PubMed2000

[Midazolam-atropine lollipop for pediatric premedication].

Strawberry flavored sweet lollipop containing midazolam (5 mg) and atropine (0.25 mg) was evaluated for the premedication of pediatric patients as judged by sedative and anti-anxious effects and gastric fluid volume and acidity. The subjects of this prospective, double blind, random and controlled study were 175 children aged between 6 months and 10 years. They were divided into three groups: group A patients receiving the lollipop containing only 5 mg midazolam (n = 78), group B patients receiving the lollipop containing only 0.25 mg atropine (n = 21), and group C patients receiving the lollipop containing 5 mg midazolam and 0.25 mg atropine (n = 76). The plasma midazolam concentration was measured in ten children in group A. The sedative and anti-anxious effects were scaled with four levels. The children receiving the lollipop containing midazolam (group A and C) showed a better level of the sedative and anti-anxious state. The volume of gastric fluid of group A was more than those of group B and C. The pH of group A gastric fluid was also higher than those of other groups. The correlation equation of the plasma midazolam concentration (y ng.ml-1) against time (t min) was y = 149 x e(-t/64), (r = 0.775). These results suggest that midazolam-atropine lollipop is one of the favorable choices as the premedication for pediatric patients.

Adjuvants, Anesthesia↗
PubMedDate not supplied

Patient refusal of surgery following Innovar premedication.

Of 1438 patients premedicated with Innovar, 10 refused to undergo surgery. During the same period, there were no refusals by 2107 patients not premedicated with Innovar. This apparent difference suggests that a prospective study of Innovar and droperidol be made to determine whether there are changes in patient attitude that lead to refusal of surgery.

Adult↗
PubMedDate not supplied

The effect of midazolam premedication on discharge time in pediatric patients undergoing general anesthesia for dental restorations.

PURPOSE: The purpose of this study was to evaluate the effect of oral premedication with midazolam on recovery times of children undergoing dental restorations under general anesthesia. METHODS: The records of 106 children (1.2-11.3 years, ASA I or II) undergoing ambulatory dental restorations were randomly selected and retrospectively reviewed: 50 subjects received midazolam (M) 0.5 mg/kg orally approximately 30 minutes prior to their procedure and 56 control subjects received no premedication (C). General anesthesia consisted primarily of inhalational anesthesia. Time in the operating room (OR), post-anesthesia care unit (PACU) and same day surgery (SDS) were determined and compared between groups. RESULTS: Both groups were similar with respect to age and weight. There were no significant differences between groups in time spent in the OR, PACU or SDS (p>0.05). In a subset of children having shorter dental procedures (OR time < or =75 minutes, n=29), there remained no significant difference in discharge times between groups. CONCLUSIONS: Preoperative administration of oral midazolam does not delay discharge of children undergoing general anesthesia for dental rehabilitation.

Ambulatory Care↗
PubMedDate not supplied

[Effect of ether-oxygen anesthesia and of the premedication agents on the toxicity and cardiotonic effect of strophanthin].

Experiments conducted with mice, rats and cats demonstrated ether-oxygen anesthesia to reduce the tolerance of the animals to strophanthin in the LD50 and MDL tests. The premedication agents (atropine, promedol, diprazine) increased, according to observations on mice and rats, the resistance of the animals to strophanthin. In tests on dogs involving determination of the cardiac ejection by thermodilution strophanthin in a dose of 44 gamma/kg and under ether-oxygen anesthesia with premedication produced a statistically significant increase of the systolic cardiac index and well-marked bradycardia. Exclusion of thepremedicationagents drastically lowered the effect of strophanthin.

Animals↗
PubMed1987

Atropine Sulfate Premedication and Cardiac Arrhythmia in Electroconvulsive Therapy (ECT).

Prophylactic effects of atropine sulfate as a premedication for cardiac arrhythmia were studied in 44 patients receiving electroconvulsive therapy in a randomized, cross-over, double-blind design. Cardiac rhythms were recorded with Holter monitors during atropine sulfate and placebo treatments. Vagal arrhythmia seemed to be reduced with atropine sulfate premedication, but the frequency of ventricular arrhythmia was not affected.

Journal Article↗