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PubMed1979

Comparison of glucagon, atropine, and placebo as premedication for endoscopy of the upper gastrointestinal tract.

The effects of 0.5 mg glucagon and 0.5 mg atropine given intravenously as premedication in upper gastrointestinal endoscopy have been examined and compared to those of placebo (0.9% NaCl) in a double-blind study involving 36 patients and 1 endoscopist. The results showed no difference between atropine, glucagon, and placebo with regard to vomiting, opening of the pylorus, feeling of discomfort, or the success of the examination. Glucagon significantly reduced peristalsis compared with both atropine (p less than 0.01) and placebo (p less than 0.01). The reflux was also significantly reduced by glucagon compared with both atropine (p less than 0.01) and placebo (p less than 0.01). No difference was found between glucagon and atropine with regard to secretion, but both drugs reduced the secretion compared with placebo (p less than 0.05). Glucagon also reduced the secretion of mucus compared with placebo (p = 0.05). No adverse effects occurred.

Aged↗
PubMed1983

Premedication in upper gastrointestinal endoscopy. A comparison of glucagon and atropine given in combination with diazepam and pethidine.

The effects of four premedication regimes on clinical variables regarded as important in upper gastrointestinal endoscopy were evaluated in a double-blind randomized study. The drug combinations were diazepam/glucagon, diazepam/atropine, pethidine/glucagon, and pethidine/atropine. No significant difference was observed among the combinations of regimes or between diazepam and pethidine or between glucagon and atropine with regard to the variables duration of examination, vomiting, secretion and maximal pyloric opening. Pethidine was more effective than diazepam in reducing salivation and pyloric reflux. Glucagon was more effective than atropine in reducing motility and reflux and was also superior to atropine with regard to diagnostic accuracy. Glucagon caused less subjective discomfort than atropine 2 h and 1 day after the investigation.

Adult↗
PubMedDate not supplied

Effects of diazepam or lidocaine premedication on propofol induction and cardiovascular parameters in dogs.

The effects of diazepam or lidocaine on the propofol induction dose and certain cardiovascular parameters were documented in this randomized, blinded study. Dogs received 0.9% saline (0.1 mL/kg intravenously [i.v.]), lidocaine (2 mg/kg i.v.), or diazepam (0.25 mg/kg i.v.) prior to propofol i.v. until loss of jaw tone was achieved (up to a maximum of 8 mg/kg). Propofol was followed by 0.3 mg/kg atracurium i.v. Direct arterial blood pressures and heart rates were recorded before premedication, induction, and intubation. No statistically significant differences were found among the groups for cardiovascular measurements or for the propofol dose required for intubation.

Analysis of Variance↗
PubMedDate not supplied

Anesthetic effects of ketamine or isoflurane induction prior to isoflurane anesthesia in medetomidine-premedicated dogs.

Dogs were given medetomidine (10 microg/kg body weight, intramuscularly) followed in 10 minutes by either ketamine (4 mg/kg body weight, intravenously) or isoflurane mask induction and maintained on isoflurane for 30 minutes. Medetomidine induced lateral recumbency in all dogs. Endotracheal intubation was faster and smoother when dogs were given ketamine than when induced with isoflurane. Analgesia was excellent in all groups. Respiratory depression was more profound when dogs were given ketamine. Recovery quality was smooth and similar among all groups. Medetomidine-premedicated dogs could be induced with either ketamine or isoflurane and maintained on 1.3% isoflurane to achieve good analgesia with smooth recovery from anesthesia.

Anesthesia, Inhalation↗
PubMed1998

Premedical program effective in increasing admissions to health professional schools.

The Special Premedical Studies Program (SPSP) has been successful in preparing Aboriginal students in Canada for admission to medicine, dentistry, medical rehabilitation, and pharmacy at the University of Manitoba. The success rate for admission to these faculties is 20%. There is a higher failure rate in the basic years of medical/dental education, but remediation has been 100% successful. Failure rates in the clinical years do not differ from those of the mainstream population. Grade point averages and MCAT scores are given less weight in the special consideration category of application at the University of Manitoba. SPSP students can and do apply to this category. The higher rate of first unsuccessful attempt in the basic years of medical education specifically can be attributed to a variety of factors, including reading skills. Although the numbers are small, we show that there is a correlation between the comprehension score of the Nelson-Denny test and the verbal score of MCAT. But there was no difference on the average between verbal score in MCAT and pass/fail in basic medical years. Students who scored above the 80th percentile on the comprehension portion of the Nelson-Denny test were successful in their first attempt at examinations in medical school.

American Indian or Alaska Native↗
PubMed2000

Effects of premedication with oral hydroxyzine on patient motion during inhalation of 32% xenon for regional cerebral blood flow mapping.

Because of its anesthetic properties, inhalation of 30-35% Xenon is associated with uncontrolled patient motion in 3-15% of the cases. This constitutes a major setback to regional cerebral blood flow studies with Xenon-enhanced computed tomography (Xe-CT CBF). The present study attempted to determine the effects of oral premedication with hydroxyzine (H) in the control of motion. Patients scheduled for Xe-CT CBF, aged 20-55 years, were randomly allocated to 3 groups: H 50 mg (n = 41), H 100 mg (n = 36) or Placebo (n = 43). The drugs were administered orally 90 minutes before Xenon inhalation. This consisted a gas mixture of 32% Xe and 25% oxygen. Motion was classified as controlled or uncontrolled depending on whether CBF data acquisition was possible or not. Anxiolysis and sedation were evaluated by a visual analogue scale. Motion was significantly reduced in the H 50 mg (0.8% vs 2.5% in the H 100 mg and 6.7% in the Placebo group). An anxiolytic effect of hydroxyzine was suggested.

Administration, Oral↗
PubMedDate not supplied

[Effect of premedication on the formation of postoperative pain syndrome].

The pronouncement degree and dynamics of pain syndrome were assessed after surgeries in the abdominal cavity organs with regard for a nature of the analgetic component of premedication and of the postoperative analgesic therapy (n = 155). The administration of analgesics before extra-traumatic surgeries was found to be compulsory in order to prevent the onset of a persistent postoperative pain syndrome. A combination of non-steroid anti-inflammatory drugs, i.e. ketonal, and of a high-efficiency agonist of opiate mu-receptors, i.e. bupranal, was acknowledged as most effective in coping with this task. It was demonstrated that the application of "the forestalling analgesia" by ketonal (100 mg in 30 min before the beginning of moderate- and mild-trauma surgical interventions and immediately after the finalization of such surgeries) contributed to an essentially lower pronouncement degree of the postoperative pain syndrome and made the administration of narcotic analgesics unnecessary. Finally, it is pointed out that promedol could not be regarded as a drug ensuring a safe prophylaxis of the central sensitization and hyperalgesia.

Adolescent↗
PubMed2004

Oral slow release dextromethorphan premedication provides a pethidine spare effect on posthemorrhoidectomy pain management.

BACKGROUND: In our previous study, we had demonstrated that intramuscular (i.m.) dextromethorphan (DM) could provide a preemptive analgesic effect and improve postoperative pain management. Regrow is a long-duration slow-release oral dextromethorphan available for clinical use with good patient compliance. The present study was designed to examine whether oral regrow may also offer the same preemptive analgesic effect as i.m. DM does in postoperative pain management. METHODS: Seventy-five patients, ASA status I and II, scheduled for hemorrhoidectomy were included and randomly assigned to the control and study groups. In the control group patients received placebo orally 8 h before surgical incision. In the study group, patients received regrow orally either 120 mg (R-120) or 240 mg (R-240) 8 h before skin incision. Pethidine (1 mg/kg, i.m.) was given for postoperative pain relief on demand. The time to first pethidine injection, total pethidine consumption, worst pain score, and pethidine-related side effects were recorded for two days. RESULTS: The times to first pethidine injection were 5.4 +/- 3.1, 6.5 +/- 3.5 and 12.7 +/- 5.7 h in the control, R-120 and R-240 groups, respectively. Total pethidine consumptions were 150 +/- 12, 132 +/- 11.8 and 82 +/- 12.5 mg in the control, R-120 and R-240 groups, respectively. The worst visual analog scale pain scores were respectively 7.2 +/- 0.4, 6.9 +/- 0.2 and 5.5 +/- 0.4 in the control, R-120 and R-240 groups during the 2-day observation. Five and three patients suffered pethidine-related side effects in the control and R-120 groups, respectively. CONCLUSIONS: This study revealed that premedication of oral regrow 240 mg provided a preemptive analgesic effect, thus reducing the severity of postoperative pain and pethidine requirement in post-hemorrhoidectomy patients.

Administration, Oral↗
PubMed2005

Single dose oral clonidine premedication does not enhance postoperative, single low dose epidural morphine analgesia in hysterectomy patients.

In this randomized, double blind placebo controlled study, the authors evaluated the effects of oral clonidine premedication on very low dose epidural morphine analgesia in 50 hysterectomy patients. Patients were randomized to receive a single oral clonidine 300 microg (n = 25) or a placebo (n = 25) 90 minutes before insertion of the epidural catheter. 3 ml of 2% lidocaine with adrenaline (5 microg ml(-1) mixed with 2 mg morphine were injected via epidural, followed by an additional volume of 2% lidocaine with adrenaline (5 microg ml(-1)) titrated to T6 block height before commencing general anesthesia. The postoperative analgesia regimen was 2 mg of intravenous morphine every 10 minutes for the first 48 hr and 1 gm of oral acetaminophen every 4-6 hr after initiation of oral diet at 24-48 hr as required. Morphine consumption, acetaminophen, pain scores, and side effects were recorded thoughout 48 hr after surgery. The results show patients in the clonidine and placebo groups were not different in terms of local anesthetics dose (p = 0.27), total morphine and acetaminophen requirement (p = 0.34, p = 0.1) respectively. Pain scores at rest and movement were also not different in both groups (p = 0.83, p = 0.64) respectively. No serious adverse effects were noted. The authors concluded that oral clonidine approximately 6 microg kg(-1) does not enhance the analgesic effect of epidural morphine 2 mg after hysterectomy.

Administration, Oral↗
PubMed2006

[Apical ballooning syndrome in a 57-year-old woman during premedication for general anaesthesia].

Apical ballooning after sudden emotional stress is a new syndrome characterised by abrupt onset of angina-like chest pain, ST-segment elevation, wall motion abnormalities involving the lower anterior wall and apex without significant coronary artery stenosis. We present a case of a 57-year-old woman with apical ballooning syndrome which occurred during premedication the general anaesthesia. We also found an increased B-type natriuretic peptide level in this patent--the finding not reported previously in the literature.

Anesthesia, General↗
PubMed2006

The influence of premedication and smoking.

The history of smoking and premedication did not influence the proportion of patients who had a cough response to fentanyl when administrated as first agent during induction in anesthesia.

Anesthetics, Intravenous↗
PubMed1991

Premedication and short term complications in iohexol discography.

In 52 patients 0.5-3.0 ml of iohexol, 180 mg/ml, was injected using lateral injection technique and fluoroscopy control. A total of 146 lumbar discs using local anaesthesia was injected. Two types of premedication were used; either diazepam alone or diazepam in combination with pethidine and glycopyrronium bromide. There was no difference in the discography injection pain between the groups (X2 = 0.774, P greater than 0.05]. During discography, some patients had nausea (2%), convulsions (4%), back pain (6%) and hypotension (10%), but no allergic reactions were seen. This suggests that these immediate reactions are more related to the procedure itself than to the non-ionic ratio 3.0 iohexol contrast medium. More troublesome iatrogenic complications were seen the day after the discography in the form of severe headache (10%) probably related to liquor leakage, and increasing low back pain (81%). The latter may be caused by local haematoma or chemical irritation from iohexol. Patients with no pain during injection had a relatively slight need for analgesics (Somer's D = -0.196, P less than 0.05).

Adult↗
PubMed1991

Comparative study of midazolam and diazepam in premedication of bronchoscopy.

Two types of benzodiazepines were used in premedication of flexible bronchoscopy. The agents were introduced in randomized, double-blind trial. Midazolam (Dormicum Hoffmann-La Roche AG) was given to 21 patients (0.07 mg/kg i.v.), diazepam (Seduxen Richter) to 22 patients (0.14 mg/kg i.v.) and placebo (saline) to 20 patients (0.07 ml/kg i.v.). Vigility, motor functions and anxiety were estimated from the application to 3 hours after endoscopy. Breathing, pulse rate, blood pressure and local reactions were followed as well. The course of bronchoscopy, anterograde amnesia and acceptability of further intervention were evaluated. Midazolam offered short term action, stronger sedative and anxiolytic effect than diazepam (48% to 27%). The anterograde amnesia was more frequent (90.5% to 55% in diazepam), acceptability of further bronchoscopy after midazolam was present in 95% of patients, after diazepam in 86% of patients. These favourable properties can be utilized especially in cases with enhanced anxiety and necessity of further endoscopies.

Adult↗
PubMed1991

[Midazolam plus ketamine as premedication for colonoscopies. A double-blind, randomized study].

In a prospective, double-blind, placebo-controlled, parallel-group, clinical study of 129 consecutive patients examined by one experienced endoscopist, we compared two premedication schedules: midazolam plus placebo and midazolam plus ketamine. 40% of the patients receiving midazolam alone needed a second injection, and 15% had to be excluded for failure. In the ketamine-group, 27% received a second injection; there were no treatment failures. The combination of both drugs proved to be safe without added risk. The combination provides more reliable sedation and analgesia and is judged as superior by the endoscopist, and patient's acceptance for re-endoscopy is higher.

Adolescent↗
PubMed1989

Comparison of droperidol 0.01 mg/kg and 0.005 mg/kg as a premedication in the prevention of nausea and vomiting in the outpatient for laparoscopy.

Patients undergoing outpatient laparoscopy and general anesthesia have a high incidence of postoperative nausea and vomiting. It is essential that anesthesia techniques accommodate the special needs of these outpatients. Droperidol is an effective antiemetic but larger doses above 1-1.25 mg may cause unwanted side effects which may prolong recovery and discharge. The current trend is to decrease the dose of droperidol to prevent side effects while still retaining the antiemetic properties. This experimental study compares droperidol 0.010 mg/kg and 0.005 mg/kg as a premedication for the prevention of nausea and vomiting in 32 female outpatients undergoing laparoscopy and general anesthesia. The patients were randomized into two groups. Group I received droperidol 0.010 mg/kg and Group II received 0.005 mg/kg as a preoperative antiemetic in double-blind fashion. Both groups received the same anesthetic for induction and maintenance of anesthesia. The patients were observed in the postanesthesia room for the incidence of nausea and vomiting. They were transported to the outpatient department and were also observed for nausea and vomiting. The t-test was used to show that there were no significant differences between groups in population characteristics. Chi-square analysis was used to determine statistical significance in the incidence of nausea or vomiting between the two groups. Analysis showed there was no statistically significant difference in the incidence of nausea or vomiting in the postanesthesia room or the outpatient department, although there was a significant clinical difference between the groups especially in the incidence of nausea in the outpatient department.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Alizapride versus placebo in premedication for esophagogastroduodenoscopy. Double-blind clinical study. Experimental research in vitro].

The pronounced antiemetic properties of Alizapride, one of the new azimidobenzamides suggested the assessment of its efficacy on 40 patients due for oesophagogastroduodenoscopy. The drug proved highly satisfactory as premedication for the examination, significantly inhibiting vomiting and stomach wall tone during the examination as was indicated by in vitro studies.

Animals↗