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At least 919 records · Page 51Linked to original sources
PubMed1984

[Midazolam as a premedication for gastroscopy].

Midazolam (Ro 21-3981; Dormicum ) is a new water-soluble benzodiazepine. Compared with diazepam and flunitrazepam, it has the advantage of a short half-life and good tolerability after intravenous administration. It induces light sleep 1/2 to 2 min after injection, and anterograde amnesia. It has minimal hemodynamic and respiratory effects. We administered midazolam by intravenous injection in a dose of 3-7 mg to 100 patients about to undergo esophago-, gastro-, or duodenoscopy. The patient became quiet and relaxed, falling into a light sleep but remaining capable of following simple instructions. After completion of the endoscopy, the patients were half awake, and listened attentively to the report. They subsequently usually slept for 1-2 h, afterwards remembering nothing of the procedure. Two (at most, 3) hours after injection, the patients were again completely awake and able to go home or back to work. In some cases, concentration was slightly impaired for the rest of the day. Compared with other premedications , midazolam is better suited for use in endoscopy, owing to its rapid onset and short duration of action.

Adult↗
PubMed1982

Premedication with intramuscular midazolam: a prospective randomized double-blind controlled study.

One hundred A.S.A. physical status I and II surgical patients were randomized to receive midazolam, 0.07 mg/kg (group M, 31 patients), hydroxyzine, 1.0 mg/kg (group H, 34 patients), or midazolam diluent as a placebo (group P, 35 patients). Drugs were administered in the vastus lateralis muscle 60 to 90 minutes before anesthesia induction. Anesthesia was induced with thiopental, 3.0 mg/kg, followed by 1.0-mg/kg increments if required. An entry criterion was that patients score greater than or equal to 50% on a subjective Anxiety Visual Analog Test (AVAT). Anxiety was also objectively rated on a six-point scale by a trained observer. Patients and observer were unaware of type of premedication used. Midazolam and hydroxyzine produced significantly (p less than 0.05) greater reduction of anxiety than placebo on both the AVAT and objective anxiety evaluations. Peak onset appeared between 30 and 60 minutes after drug administration. Hemodynamic changes were similar in all groups, and no untoward reactions were encountered before anesthesia. The injection site 24 and 48 hours after administration showed evidence of mild tissue irritation in 68% of patients in group H, 26% of patients in group M, and none of the patients in group P. Midazolam is an efficacious, safe premedicant in relatively healthy patients. It has a prompt onset of action with only minimal tissue irritation.

Anxiety↗
PubMedDate not supplied

[Clinical study of the pharmacodynamics of drugs used for premedication].

The use of premedication varieties in surgical treatment of 52 patients with heart diseases of varying etiology has demonstrated that the most effective were antihypoxic agents (sodium hydroxybutyrate), substances reducing myocardial requirement of oxygen (cardiac glycosides) and decreasing load of the heart (anapriline, verapamil), normalizing myocardial function (a polarizing mixture, cardiac glycosides), antithrombotic substances (heparin), antihistamine and antishock agents (diphenhydramine, pipolphen, morphine, promedol, prednisolone, neuroleptics, tranquilizers), and substances that enhance the neutralizing liver function (vitamins B and C). Drug correction of the functional and biochemical indicators should be strictly individualized with regard to the patient's age, type of pathology, and the scope of the coming surgical intervention.

Adolescent↗
PubMed1980

[Comparison of the effect of premedication with diazepam and trazodone on anesthesia induced with althesin].

Interference on the part of premedication with diazepam and trazodone with althesin anaesthesia was investigated and compared by means of variance analysis according to Fisher, and the X2c test according to Yates, in 150 patients aged 35-45 yr in three groups of 50 during examination of the uterine cavity. No marked difference between the effects of the two drugs were noted, with two exceptions: 1) trazodone was better able to potentiate the hypnotic action of althesin, so that less was needed for the induction of anaesthesia; 2) patients pretreated wih diazepam displayed a marked increase in postoperative somnolence, this being an expression of the drug's hypnotic effect.

Adult↗
PubMed1980

[Fatal hyperthermic crisis after premedication. Human stress syndrome or trigger effect of promethacine (author's transl)].

A case report of a fatal hyperthermic crisis after premedication and before introduction of anaesthesia is given. Based on the typical clinical course, CK isoenzyme patterns and preliminary results of familial investigation the diagnosis of malignant hyperthermia could be established. According to literature reports, psychic stress and/or phenothiazine medication may be assumed as triggering factors. Until a potential causality between malignant hyperthermia and phenothiazine medication can definitely be ruled out, their use in suspicious cases of susceptibility to malignant hyperthermia should be avoided.

Adolescent↗
PubMed1980

Low-dose intramuscular ketamine and hyaluronidase for induction of anaesthesia in non-premedicated children.

The efficacy of low-dose intramuscular ketamine and hyaluronidase as an induction agent was studied in non-premedicated paediatric outpatients. With 40-50% of the hitherto minimum recommended dose a high success rate of induction was achieved, while the recovery time was considered satisfactory for outpatient anaesthesia. Side-effects were minimal and there were no instances of unpleasant dreams or emergence phenomena.

Anesthesia, General↗
PubMed1995

[The efficacy of midazolam-famotidine suppository for premedication in children].

We evaluated the efficacy of midazolam-famotidine suppository (M-F suppository) for premedication in children. After obtaining informed parental consent, we studied children aged 5m-7y, ASA I status, scheduled for minor elective surgery. The suppository group (n = 26) was given suppository of both midazolam 0.5 mg.kg-1 and famotidine 2 mg.kg-1, and the intramuscular injection group (n = 19) was given hydroxyzine 1 mg.kg-1. In the suppository group, gastric pH (3.90 +/- 0.34) was significantly higher, and gastric volume (1.88 +/- 0.54 ml) was significantly less than in the intramuscular injection group (1.82 +/- 0.15, 8.42 +/- 1.76 ml). The M-F suppository may offer similar sedative effect as an intramuscular injection of hydroxyzine. We concluded that the M-F suppository is an effective premedicant for pediatric patients.

Administration, Rectal↗
PubMed1994

[Efficacy of oral midazolam as premedication in adult].

Midazolam was administered as a premedicant to 90 patients aged from 20 to 55 years with ASA status 1 or 2. The patients were divided into 3 groups: group I 10 mg orally, group II 20 mg orally, group III 5 mg intramuscularly. All premedications were given 30 minutes before entering the operating room. The perioperative effects of midazolam on blood pressure, pulse rate, respiratory rate and SpO2 as well as sedative, hypnotic and amnemonic effects were evaluated in these patients. There were no remarkable changes in the blood pressure, pulse rate or respiratory rate. There was no problem on the upper airway tract, but a slight decrease in SpO2 was observed in a few patients. In this study, sedative and hypnotic effects were almost satisfactory. Midazolam produced significant anterograde amnesia, and the amnemonic rate was 66.7% in group I and 86.7% in group II and III. In conclusion, oral midazolam is an effective preanesthetic medication in adult.

Administration, Oral↗
PubMed1994

Anticholinergic premedication for fibreoptic bronchoscopy.

Atropine is routinely used as part of the premedication regimen for fibreoptic bronchoscopy. This study was performed, firstly, to evaluate the effect of anticholinergic agents on the ease of bronchoscopy, haemodynamic parameters and patient comfort during the procedure; and secondly, to compare atropine with glycopyrrolate, a newer acetylcholine antagonist which is claimed to cause less tachycardia and sedation, whilst suppressing salivation more effectively. One hundred and ninety consecutive patients were randomly allocated to three treatment groups: diazepam 5 mg; diazepam 5 mg + atropine 600 micrograms; and diazepam 5 mg + glycopyrrolate 300 micrograms. Diazepam was given orally one hour before bronchoscopy, and glycopyrrolate/atropine intramuscularly 30 min before bronchoscopy. All patients received thalamonal intravenously, lignocaine gel into one nostril, and lignocaine by transtracheal injection just prior to the procedure. The incidence of bronchoscopy related haemodynamic problems was similar in all three groups. Troublesome coughing, as observed by the operator, was less frequent with glycopyrrolate (control 51%, atropine 42%, glycopyrrolate 30%), as was patient movement (40%, 32%, 19%, respectively). Uncomfortable dryness of the mouth was most common with glycopyrrolate (37%, 32%, 66%, respectively), but overall assessment of discomfort, and the number of patients who would agree to a repeat bronchoscopy (73%, 76%, 70%, respectively) were very similar in all three groups. In conclusion, the differences between the three groups were slight. Glycopyrrolate made the bronchoscopy slightly easier for the operator because of significantly improved cough and movement suppression, though atropine was marginally preferable in terms of patient comfort.

Administration, Oral↗
PubMed1994

Oral midazolam as premedication for the apprehensive child before dental treatment.

A double-blind study was undertaken to determine the efficacy of an oral dose of midazolam 7.5 mg as compared to placebo in a sample of 32 children who had refused dental care after the conventional psychological approach alone was used to reduce fear and apprehensive behavior. Parameters assessed before and 30 minutes after the oral administration of either midazolam or placebo were mental attitude, hypnotic activity, motor activity, quality of sedation and of dental treatment. A three-point scale was designed in each studied parameter and mean values +/- s.e.m. were compared before and after treatment by using Wilcoxon's rank test. It was shown that an oral dose of midazolam 7.5 mg significantly improved all parameters under evaluation (p < 0.01) as compared to placebo, effects which appeared thirty minutes after administration. It is concluded that oral midazolam provides a fast and adequate sedation in children refusing dental care. Thus, the drug is an alternative to other sedative or hypnotic drugs currently used in the premedication of the apprehensive child.

Anesthesia, Dental↗
PubMed1993

[Alprazolam as premedication in ophthalmologic surgery].

Oral premedication with alprazolam was studied in 83 patients before eye surgery. Alprazolam appears to be an excellent anxiolytic drug, with minor cardiovascular and respiratory side effects. A double blind study should be carried on to assess these properties.

Administration, Oral↗
PubMed1996

[Premedication with midazolam in adults with special reference to anxiety treatment].

Investigations were made in more than 2,500 adult patients into desired effects and undesirable side-effects following an average premedication dosis of 6.1 mg midazolam administered intramuscularly. Particular interest was directed to the anxiolytic effect of this benzodiazapine. Midazolam proved to be an effective sedative and anxiolytic drug with no remarkable effects on vigilance and cooperation during induction of anaesthesia. Midazolam was well accepted by the patients and showed only slight side-effects.

Adult↗
PubMed1996

[Usefulness of alpha 2-adrenoceptor agonists and practical problems associated with their use in clinical anesthesia--1. Premedication, anesthetic adjuvants, and hemodynamic effects].

A great deal of new information on alpha 2-adrenoceptor agonists has recently been accumulated in humans; alpha 2-agonists have several beneficial actions in clinical anesthesia including sedative, anxiolytic as well as analgesic effects, improved hemodynamic stability, and etc. In the first part of this review, we summarized the structure, signal transmission and basic pharmacology of alpha 2-adrenoceptor agonists (clonidine and dexamedetomidine), and evaluated their usefulness for premedication, and as anesthetic adjuvants as well as agents for stabilizing circulation in the clinical settings. In addition, we referred to practical problems associated with their use.

Adjuvants, Anesthesia↗
PubMed1997

[The effects of premedication on induction doses of propofol and hemodynamic responses during induction].

We chose five sedatives for premedication and investigated the effect of these drugs on the induction doses of propofol. One hundred patients were allocated into one of five groups of 20. These groups consisted of control group (C) given only atropine 0.5 mg i.m.; CL group (plus clonidine 0.15 mg orally); H group (plus hydroxyzine 25 mg i.m.); M group (plus midazolam 3 mg i.m.) and D group (plus diazepam 10 mg orally). The induction dose was measured using loss of count technique. Arterial pressure and heart rate were measured, before and after propofol induction as well as after intubation. We also calculated rate pressure products (RPP) at each point. The induction doses were significantly lower in M-group than those in C-group. On the other hand, in hemodynamic responses, RPP was unchanged in any groups after propofol induction and after the intubation. Both propofol and midazolam have been known to have a depressive effect on the central nervous system via GABA-A receptor-mediated inhibition, although the exact receptor for propofol is unknown. We thought, therefore, that when the interaction occurred, both midazolam and propofol had the same effect on the GABA-A receptor and increased chloride ion flux through the channels. Hydroxyzine and clonidine, however, do not share a common receptor or exert effect on the GABA-A receptor. We consider that this was one of the reasons why induction doses of both H and CL group could not decrease significantly. We concluded that midazolam 3 mg decreased propofol induction dose significantly. Both midazolam 3 mg and clonidine 0.15 mg decreased RPP before induction and hemodynamic responses to induction and intubation were stable.

Adult↗
PubMed1976

[The synthetic saliva--a supplement to the premedication (author's transl)].

An undesirable side-effect of the anticholinergic drugs used in the premedication is an unpleasent drying of the mouth and pharynx. According to the experience of the authors, this often distressing feeling can be successfully relieved by means of application of synthetic saliva. This is of special importance for patients operated under reginal anaesthesia.

Anesthesia, Conduction↗