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At least 829 records · Page 46Linked to original sources
PubMed1985

Effect of premedication with controlled-release oral morphine on postoperative pain. A comparison with intramuscular morphine.

Thirty fit patients presenting for elective total hip replacement were randomly allocated to receive a premedication of 60 or 90 mg controlled-release oral morphine or 15 mg intramuscular morphine. Postoperative analgesia was assessed using on-demand intravenous pethidine supplementation requirements. In 15 patients free plasma morphine concentrations were measured. Both 60 and 90 mg controlled-release oral morphine led to a reduced pethidine requirement compared to the intramuscular group but the reduction was not statistically different.

Administration, Oral↗
PubMed1986

Cardiac dysrhythmias during oral surgery. Comparison of hyoscine and droperidol premedication.

The incidence of cardiac dysrhythmias during inpatient dental anaesthesia under halothane was studied following either hyoscine or droperidol as a supplement to papaveretum for premedication. Forty-three percent of patients given hyoscine exhibited cardiac dysrhythmias compared to 23 percent of the group given droperidol (p = 0.03). The incidence of dysrhythmias bore no relationship to the age, sex or weight of the patient, nor to the end tidal carbon dioxide tension.

Adolescent↗
PubMed1987

The influence of premedication on the occurrence of dysrhythmias during oral surgery.

The incidence of cardiac dysrhythmia during inpatient dental anaesthesia with enflurane was studied following either hyoscine or droperidol as a supplement to papaveretum premedication. None of the subgroup given droperidol exhibited dysrhythmias, compared to 4.4% of those patients given hyoscine. This difference was not significant at the 5% level (0.2 greater than p greater than 0.1).

Adolescent↗
PubMed1988

Premedication with oral slow release morphine in dental anaesthesia. A comparison with temazepam.

Oral slow release morphine 30 mg and temazepam 30 mg given as premedication 2 hours before operation were compared in 62 patients who underwent extraction of four third molar teeth in a randomised double-blind trial. There was no significant difference in pre-operative sedation; the majority were mildly or moderately sedated. Patients in the morphine group woke up significantly faster and had significantly reduced requirements for analgesics after operation.

Administration, Oral↗
PubMed1988

Hypoxaemia after premedication in cardiac patients. Glycopyrronium compared with hyoscine.

Arterial blood gases were analysed before and approximately one hour after premedication in two groups of 10 patients awaiting cardiac surgery. One group received intramuscular papaveretum and hyoscine, the other papaveretum and glycopyrronium. Similar, small but statistically significant reductions in mean arterial oxygen tension and oxygen saturation, and increases of arterial carbon dioxide tension occurred in both groups. Hypoxaemia in individual patients was unpredictable and in some was clinically relevant.

Drug Combinations↗
PubMed1988

A comparison of midazolam and temazepam for premedication of day case patients.

One hundred patients who underwent day case surgery took part in a randomized double-blind comparison between midazolam 15 mg and temazepam 20 mg orally as premedicants. Postoperative recovery was studied using tests of psychomotor function. Midazolam produced a similar degree of anxiolysis to temazepam and a greater incidence of drowsiness. Recovery was similar after either premedicant and psychomotor function was still depressed 4 hours postoperatively (p less than 0.001). Nearly 90% of patients felt that they had benefitted from either premedicant. We conclude that midazolam is a suitable drug for premedication in day case surgery.

Adolescent↗
PubMed1990

Behaviour of small children before induction. The effect of parental presence and EMLA and premedication with triclofos or a placebo.

The effect of the prescription of triclofos 70 mg/kg orally 90 minutes before operation on the behaviour of 263 children aged 1 to 5 years was studied in a blind, randomised, placebo-controlled trial. EMLA was applied to the dorsum of one hand when the premedication was administered, and all the children were accompanied by a parent during induction of anaesthesia. The frequency of satisfactory behaviour was significantly higher in the triclofos group (p less than 0.02), but the time spent in the recovery ward was increased.

Age Factors↗
PubMed1990

Oral premedication in children. A comparison of trimeprazine with a trimeprazine, droperidol and methadone mixture.

One hundred children who presented for minor general surgical procedures were randomly assigned to receive one of two oral premedications. Those in group A (n = 50) were given 3 mg/kg of trimeprazine and those in group B (n = 50) a mixture of trimeprazine 1.0 mg/kg, droperidol 0.15 mg/kg and methadone 0.08 mg/kg. Patients in group B were more likely to be asleep on arrival in the anaesthetic room (p less than 0.02) and were less likely to be distressed at induction of anaesthesia (p less than 0.02). Thiopentone requirements were less in group B (p less than 0.001). The incidence of side effects was similar in the two groups. It is concluded that the mixture produces more satisfactory sedation than trimeprazine.

Administration, Oral↗
PubMed1993

Dexmedetomidine as intramuscular premedication in outpatient cataract surgery. A placebo-controlled dose-ranging study.

Alpha 2 agonists have been shown to decrease intra-ocular pressure in ophthalmic surgery. We studied the effects of dexmedetomidine, a new alpha 2 agonist, on intra-ocular pressure, haemodynamic parameters, sedation, anxiolysis and dryness of mouth in 35 (ASA physical status 1-3) patients undergoing day-case cataract surgery under peri-ocular anaesthesia. Five different doses of dexmedetomidine (0.25, 0.5, 0.75, 1.0 and 1.5 micrograms.kg-1) were used in this double-blind, randomised and placebo-controlled study. The trial drug was administered into the deltoid muscle 60 min before surgery. The 1.0 micrograms.kg-1 dose of dexmedetomidine produced a 32% reduction of intra-ocular pressure (p = 0.002). This dose induced moderate sedation, but was not associated with significant haemodynamic changes. A significant decrease in heart rate and systolic blood pressure was seen only with the highest dose of dexmedetomidine. Our results suggest that dexmedetomidine 1.0 micrograms.kg-1 produces sedation and a reduction of intra-ocular pressure with minimal haemodynamic side effects when given intramuscularly as premedication before cataract surgery under regional anaesthesia.

Adrenergic alpha-Agonists↗
PubMed1987

Assessment of a new hypnotic imidazo-pyridine (zolpidem) as oral premedication.

1 A new imidazo-pyridine hypnotic (zolpidem 10 mg and 20 mg) was compared with placebo as premedication before general anaesthesia in female patients undergoing minor gynaecological surgery. Efficacy and tolerance before and after anaesthesia were assessed. Psychomotor testing was used to study recovery from anaesthesia. 2 Both doses of zolpidem produced good sedation pre-operatively but only the higher dose was associated with anterograde amnesia. 3 Premorbid anxiety scores were low in the group of patients studied and were unaffected by either dose of zolpidem. 4 There were no significant effects on the course of anaesthesia. However, postoperatively there was a tendency for wake-up to be delayed in those patients who received either dose of zolpidem. 5 Postoperative recovery, as indicated by tests of psychomotor performance, was noticeably delayed with a dose of 20 mg compared with placebo whilst psychomotor performance had returned towards baseline levels 3 h after wake-up in those patients who had received placebo. The zolpidem 10 mg group was intermediate. 6 Zolpidem may be a suitable premedicant when hypnosis and amnesia only are required.

Adult↗
PubMed1984

Cardiorespiratory effects of nalbuphine and morphine premedication in adult cardiac surgical patients.

Premedication for cardiac surgical patients attempts to achieve relief of anxiety with minimal or no cardiorespiratory changes. Nalbuphine (NUBAIN) and morphine produced similar decreases in respiratory rate (1-3 breaths per min) and PaO2 (averaging 1.34 kPa), and increases in arterial PaCO2 (averaging 0.56 kPa). Cardiovascular changes were not seen with either agent. A similar degree of sedation and relief of anxiety was achieved with both drugs. Side effects were minimal and infrequent. Nalbuphine produces respiratory depression and sedation without cardiovascular changes which is comparable to an equivalent dose of morphine in patients with either valvular or coronary artery disease.

Carbon Dioxide↗
PubMed1985

Sublingual buprenorphine for premedication and postoperative pain relief in orthopaedic surgery.

The effect of sublingual buprenorphine (Temgesic) as a premedicant and for postoperative pain relief compared with morphine/pethidine was studied in 50 patients scheduled for elective surgery of the knee joint. Twenty-five patients received buprenorphine 0.4 mg sublingually 1 h before surgery and the same dose on demand postoperatively. Twenty-five patients were given morphine intramuscularly (7.5 mg or 10 mg to females and males respectively) 1 h preoperatively. This group received pethidine (75 mg) intramuscularly on demand postoperatively. All the patients were anaesthetized with halothane N2O/O2 after induction with thiopentone. No significant differences were found with regard to sedation, dizziness, nausea and vomiting during the study period. Emergence shivering, confusion and restlessness just after termination of the operation were equal in the two groups. In the recovery room, however, there was a higher frequency of shivering (P less than 0.05) in the morphine group. During the first 24 h postoperatively the buprenorphine group was given an average of 3.8 doses compared with 2.3 in the pethidine group (P greater than 0.05). It is concluded, that buprenorphine sublingually is as good as morphine intramuscularly for premedication and therefore should be recommended to patients who wish to avoid injections. For postoperative pain relief the initial dose of buprenorphine should be given intravenously. Only minor and unimportant side effects were seen.

Administration, Oral↗
PubMed1985

Rectally administered morphine: plasma concentrations in children premedicated with morphine in hydrogel and in solution.

Seventeen healthy children undergoing eye surgery in general anaesthesia were given morphine rectally for premedication. Six patients (Group I) were given morphine 0.15 mg X kg-1 in a propylene glycol solution also containing diazepam and hyoscine. Eleven patients (Group II) were given morphine 0.5 mg X kg-1 in a starch hydrogel preparation. The plasma concentrations of morphine (Groups I and II) and diazepam (Group I) were studied. After the lower dosage of morphine the plasma concentrations never exceeded 10 ng X ml-1, whereas the mean peak plasma concentration was 25.3 +/- 5.5 ng X ml-1 after the higher dosage. One child in each of Groups I and II needed postoperative analgesics. The simultaneous plasma concentration of morphine was then lower than 5 ng X ml-1. Postoperative nausea occurred to about the same extent in both groups. It is suggested that morphine given rectally in a starch hydrogel may be an alternative to oral and parenteral routes of administration.

Anesthesia, General↗
PubMed1987

Oral premedication with clonidine: effects on stress responses during general anaesthesia.

The effect of clonidine (4.5 micrograms kg-1) on haemodynamics and hormonal stress responses was evaluated in 21 female patients undergoing breast surgery. The standardized general anaesthesia included diazepam as premedicant, thiopentone, enflurane, N2O, fentanyl and vecuronium. Venous plasma concentrations of noradrenaline, adrenaline, growth hormone, vasopressin, and cortisol were assayed at various times before, during and after surgery. Clonidine attenuated the sympathoadrenal response; arterial blood pressure and heart rate increases in association with intubation were lower in clonidine-premedicated patients. Noradrenaline levels were lower throughout and 3 h after surgery in the clonidine group (P less than 0.05). Adrenaline levels were lower in this group 2 min after intubation (P less than 0.05). Growth hormone, vasopressin and cortisol plasma levels were increased at the end of and after surgery, with no differences between the groups. In spite of the effect on sympathoadrenal response, clonidine did not have any significant additive anxiolytic effect. Statistically significant differences were not found as to need for postoperative analgesics.

Administration, Oral↗
PubMed1988

Comparison of rectal to intramuscular administration of midazolam and atropine for premedication of children.

The effectiveness of midazolam and atropine as anaesthetic premedication was investigated, comparing rectal to intramuscular administration. A total of 202 children varying in age from 10 months to 9 years, who had been admitted to the Day Surgery Department for short ENT procedures, were assigned to one of two groups on a random basis. The first group (n = 102) was given 0.5 mg/kg midazolam and 0.05 mg/kg atropine as a rectal solution 30 to 75 min prior to induction, while the second group (n = 100) was given 0.15 mg/kg midazolam and 0.02 mg/kg atropine as an intramuscular injection 20 to 60 min prior to induction. The levels of sedation and salivation were compared, as was the degree of tolerance to intravenous induction. The parents of children older than 3 years of age were given a questionnaire designed to determine the degree of amnesia. We found this combination of drugs to be effective in the relief of anxiety, the inhibition of salivary secretion and the promotion of memory loss, regardless of the route of administration. We feel that rectal administration is preferable because it is not associated with pain or anxiety.

Administration, Rectal↗