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At least 775 records · Page 43Linked to original sources
PubMed1975

The effect of intravenous premedication with lorazepam (ativan), pentobarbitone or diazepam on recall.

Sixty-nine patients undergoing regional anaesthesia were premedicated with either lorazepam (1, 2, 3 or 5 mg), diazepam (5 or 10 mg), pentobarbitone (50 mg) or placebo given i.v., on a double-blind, randomized basis. A simple yet rigorous protocol was used to test the effect of these drugs on anterograde recall. Lorazepam 3 and 5 mg was found to affect anterograde recall significantly. None of the other drugs tested affected recall.

Adult↗
PubMed1977

Ketamine as the sole anaesthetic agent for laparoscopic sterilization. The effects of premedication on the frequency of adverse clinical reactions.

Ketamine, as the sole anaesthetic agent, was assessed in a double-blind study of 135 female patients who underwent laparoscopic sterilization. The patients were allocated randomly to one of four groups according to the type (pentobarbitone or droperidol) and route (i.v. or i.m.) of premedication. In addition all the patients received hyoscine i.m. Neither pentobarbitone nor droperidol prevented adverse emergence reactions and the total frequency of dream-like activity. However, patients who received pentobarbitone i.v. did not recall unpleasant dream-like activity. Patients who received droperidol i.v. had the shortest recovery time after ketamine anaesthesia. There was a high incidence of visual disturbances in all groups. Droperidol protected against the initial increase of heart rate, and pentobarbitone against the increase in arterial systolic pressure associated with ketamine.

Adult↗
PubMed1977

Respiratory effects and amnesia after premedication with morphine or lorazepam.

Lorazepam, a new benzodiazepine, was compared with morphine for premedication. Ten patients received morphine 10 mg/70 kg i.m. and 10 received lorazepam 4 mg/70 kg i.m. Respiratory effects were assessed from the change in slope (S) and intercept (B) of the carbon dioxide response line, using a development of Read's rebreathing method. Morphine depressed S by 47% (P less than 0.01), but after lorazepam S increased by 27% (P less than 0.05), neither drug altering B significantly. In two volunteers lorazepam was assessed by both the rebreathing and the steady-state methods; after lorazepam S was smaller by the steady-state than by the rebreathing technique. The findings for lorazepam are consistent with the known effects of sleep on carbon dioxide sensitivity. Amnesia lasting 4-8 h occurred in all patients who received lorazepam so that pain and nausea during this period were not recalled, but no patient who received morphine experienced amnesia. We conclude that lorazepam merits further study, particularly where sedation without respiratory depression is needed, as in obstetrics, and where amnesia for uncomfortable procedures is required.

Adolescent↗
PubMed1978

Droperidol, fentanyl and morphine for i.v. surgical premedication.

Fentanyl 0.1 mg and morphine 10 mg alone and in combination with droperidol 2.5 and 5.0 mg were studied for i.v. surgical premedication in 240 patients. Relief of anxiety, sedation, lack of recall, patient acceptance and side-effects were evaluated. The addition of droperidol to fentanyl and morphine produced greater sedation and relief of anxiety before operation, but did not improve patient acceptance or lack of recall.

Adolescent↗
PubMed1981

Depression of respiratory drive by diazepam as premedication.

The respiratory effects of premedication with i.v. injection of diazepam have been assessed in 10 healthy patients awaiting minor operative procedures. Measurements were recorded before and 60 min after administration of diazepam 0.14 mg kg-1. Mouth occlusion pressure (P 0.1) was used as an index of neuromuscular inspiratory drive. Minute-ventilation (VE), respiratory frequency (f) and mean inspiratory flow rate (VT/TI) were significantly reduced after diazepam. During carbon dioxide rebreathing the slopes of VE, f, VT/TI and P 0.1 with PACO2, were significantly reduced. These results confirm that i.v. diazepam produces significant respiratory depression in healthy subjects. We conclude that diazepam used under clinical conditions depresses the respiratory centre.

Adult↗
PubMed1982

Comparative study of lorazepam and trimeprazine for oral premedication in paediatric anaesthesia.

One hundred and ninety-nine children received lorazepam 0.05 mg kg-1 or trimeprazine 3 mg kg-1 as oral premedication in a double-blind trial. Lorazepam proved more palatable and produced a cheerful demeanour, but possessed no significant advantages on overall assessment before surgery. Following operation, restlessness with vomiting, and evidence of retrograde amnesia occurred more frequently with lorazepam.

Administration, Oral↗
PubMed1983

Effect of premedication on drug absorption and gastric emptying.

The rate of paracetamol absorption after oral administration was used as a model of drug absorption and as an indirect measure of the rate of gastric emptying in 37 patients awaiting elective general surgery after different premedications. After saline (control) and diazepam, paracetamol absorption was normal but after morphine or nefopam, absorption was delayed markedly, presumably as a result of delayed gastric emptying. After naloxone there was a small but insignificant delay.

Acetaminophen↗
PubMed1983

Sublingual lorazepam: a better premedication?

The efficacy of a sublingual preparation of lorazepam was compared with an i.m. injection of lorazepam as premedication for 150 patients undergoing minor gynaecological surgery. Anxiety, arousability and recall of auditory, visual and tactile stimuli were used as measurements of the degree and rate of onset of the effects. Anxiety scores decreased in both groups after medication. Patients who received the drug sublingually showed less recall, an earlier onset of sedation, more drowsiness and a longer recovery time than those who received the drug i.m. It is concluded that lorazepam given by the sublingual route is superior to that given i.m. because of more rapid absorption resulting in earlier drowsiness and more amnesia. An additional advantage is the absence of the discomfort of an injection.

Administration, Oral↗
PubMed1984

Premedication with butorphanol. A comparison with morphine.

A blind comparison was made of butorphanol 2 mg with morphine 10 mg i.m. as the sole premedication in four groups, each of 10 women, undergoing total abdominal hysterectomy. On both subjective and objective grounds, butorphanol was as effective as morphine with the advantage of fewer unwanted side-effects, although one patient complained of hallucinations. No clinically significant antagonism could be demonstrated between butorphanol and fentanyl. One patient gave accurate recall of intraoperative events, which reflects the problem of designing a properly constructed scoring system, based on basic clinical signs, to predict accurately the adequacy of anaesthesia.

Adult↗
PubMed1985

Comparison of midazolam, diazepam and placebo i.m. as premedication for regional anaesthesia. A randomized double-blind study.

In a randomized double-blind study, midazolam 0.1 mg kg-1 i.m. was compared with diazepam 0.2 mg kg-1 and placebo as premedication for patients undergoing urological interventions under spinal anaesthesia. The sedative and anxiolytic effects of midazolam were evident 5-10 min after administration, and were maximum between 30 and 90 min. After this, rapid recovery was observed. More than 90% of the patients receiving midazolam were totally or partially amnesic for the procedures in the induction room and the operation theatre. Amnesia was not seen in the patients receiving diazepam or placebo and, in contrast to midazolam, diazepam had almost no sleep-inducing effect. In a few patients, the depth of sleep achieved with midazolam 0.1 mg kg-1 was such that co-operation was impaired.

Aged↗
PubMed1986

Dose requirements of propofol by infusion during nitrous oxide anaesthesia in man. I: Patients premedicated with morphine sulphate.

The study was performed to determine the ED50 and ED95 of a continuous infusion of the emulsion formulation of propofol during 67% nitrous oxide anaesthesia in 57 patients premedicated with morphine sulphate 0.15 mg kg-1. Anaesthesia was induced with propofol 2 mg kg-1, and maintained before incision with a fixed-rate infusion of propofol to supplement nitrous oxide. The response to the first surgical incision, made at least 30 min after induction of anaesthesia, was observed. The ED50 was 53.5 micrograms kg-1 min-1 and the ED95 was 112.2 micrograms kg-1 min-1. At the time of the first surgical incision, the venous whole blood concentrations of propofol at the ED50 and ED95 infusion rates (EC50 and EC95) were 1.66 micrograms ml-1 and 3.39 micrograms ml-1, respectively. The satisfactory maintenance of anaesthesia provided by nitrous oxide supplemented with propofol was associated with haemodynamic stability and rapid, uncomplicated recovery.

Adult↗
PubMed1987

Dose requirements of propofol by infusion during nitrous oxide anaesthesia in man. II: Patients premedicated with lorazepam.

The infusion rate of propofol required to supplement 67% nitrous oxide in oxygen to maintain surgical anaesthesia was determined in 72 patients premedicated with lorazepam. Following an induction dose of propofol 2 mg kg-1, groups of eight patients received an infusion of propofol varying from 60 to 200 micrograms kg-1 min-1. Probit analysis was used to determine the ED50 (130 micrograms kg-1 min-1; 95% confidence limits: 106-167 micrograms kg-1 min-1) and ED95 (348 micrograms kg-1 min-1; 95% confidence limits: 233-1296 micrograms kg-1 min-1) for propofol infusion. Whole blood propofol concentrations at the time of surgical incision correlated strongly with the infusion rate, giving an EC50 value of 2.5 micrograms ml-1, and an EC95 value of 5.92 micrograms ml-1. There was no significant correlation between the rate of infusion of propofol, or the total propofol dose, and the times to response to command, or to recall of birthdate.

Adolescent↗
PubMed1987

Comparison of temazepam elixir and trimeprazine syrup as oral premedication in children undergoing tonsillectomy and associated procedures.

Temazepam 0.5, 1.0 and 1.5 mg kg-1 in an elixir formulation (Euhypnos Elixir), was compared with trimeprazine tartrate 3 mg kg-1 in a syrup (Vallergan Forte Syrup), as premedication in 220 children (ASA grade I) undergoing tonsillectomy and associated procedures. Each patient was randomly allocated to one of the four treatments. The administration was blind to the observers in theatre, recovery room and postoperative ward, who assessed each patient according to a total of 14 criteria. A modelling technique allowed account to be taken of the effects of concomitant variables (e.g. age and duration of anaesthesia) where appropriate. No statistically significant difference was found between the efficacy of the treatments. The only statistically significant differences were that temazepam was associated with more ectopic beats under anaesthesia (P = 0.03 or 0.002, depending on the test applied), more postoperative vomiting (P = 0.04) and more postoperative restlessness (P less than 0.0001).

Adolescent↗
PubMed1987

Effects of fasting and oral premedication on the pH and volume of gastric aspirate in children.

The pH and volume of gastric aspirate were measured immediately after the induction of anaesthesia in 224 healthy children to determine the effects of decreasing the period of fasting and of giving oral premedicants before anaesthesia. Fasting for less than 4 h was found to increase the volume of gastric aspirate and the risk of developing pulmonary aspiration syndrome. Trimeprazine syrup was found to increase the pH of the gastric contents, and decrease the likelihood of the pulmonary aspiration syndrome. There was a significant increase in gastric volume in patients premedicated with temazepam elixir which did not occur in patients given temazepam capsules. These results support the custom of fasting patients for at least 4 h before anaesthesia and indicate that oral premedicants and their vehicles can have significant effects on the stomach.

Administration, Oral↗
PubMed1989

Effects of temazepam premedication on cognitive recovery following alfentanil-propofol anaesthesia.

The effects of temazepam 20 mg and placebo were compared for premedication in patients anaesthetized with propofol and alfentanil and undergoing day surgery. Temazepam 20 mg significantly reduced preoperative anxiety and increased recovery time. A series of computerized cognitive tasks revealed significant deficits in attention and memory following anaesthesia, which were increased in range and magnitude by temazepam, which were apparent 30 min after surgery and had largely, but not completely, recovered at 4 h. This study has demonstrated that computerized cognitive testing can identify a wider profile of impairments produced by temazepam than has been found in previous work using non-computerized techniques.

Adolescent↗
PubMed1990

Effect of i.v. metoclopramide on gastric emptying after opioid premedication.

Metoclopramide was given i.m. or i.v. to patients who had been given an opioid premedication, and the effects on gastric emptying assessed. Forty patients were allocated randomly to one of four treatment groups: group 1, oral diazepam 10 mg; group 2, i.m. morphine 10 mg; group 3, i.m. morphine 10 mg and i.v. metoclopramide 10 mg; group 4, i.m. morphine 10 mg and i.m. metoclopramide 10 mg. Gastric emptying was estimated from the absorption of oral paracetamol. I.v. metoclopramide antagonized the reduction in paracetamol absorption caused by morphine, whereas i.m. metoclopramide did not. This finding may be of importance in anaesthesia for emergencies.

Acetaminophen↗
PubMed1992

Effect of pethidine premedication and halothane anaesthesia on upper limb blood flow.

Forearm blood flow (FBF), hand blood flow (HBF) and arterial pressure were measured in 12 patients, before and after premedication with pethidine and during halothane anaesthesia. After pethidine there was a significant (P less than 0.01) increase in HBF (180%) and decreased hand vascular resistance; heart rate also increased significantly (P less than 0.05), whilst mean arterial pressure (MAP) did not change. The large increase in HBF without hypotension suggests a local effect. With halothane, there was a significant (P less than 0.05) decrease in MAP, increase in HBF and decrease in hand vascular resistance compared with either control or effects produced by pethidine; there was a significant decrease in FBF and reversal of the action of pethidine on forearm vascular resistance.

Adult↗