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PubMedDate not supplied

Atropine and glycopyrronium premedication. A comparison of the effects on cardiac rate and rhythm during induction of anaesthesia.

The effect of premedication with the cholinergic blocking drugs, atropine and glycopyrronium, was investigated in two groups, each of twenty patients, with regard to their effects on cardiac rate and rhythm during induction of anaesthesia and tracheal intubation. Another similar group of twenty patients was given no anticholinergic premedication. The incidence of dysrhythmias was 35% in the atropine group and 10% in the glycopyrronium group but there were no dysrhythmias in patients given no anticholinergic drug. The average rises in arterial pressure were similar in all three groups. Atropine administration led to a greater initial rise in heart rate before the induction of anaesthesia, although the average heart rates were similar in the three groups at the time of intubation and cuff inflation. The routine use of anticholinergic premedication seems to be unnecessary since the antisialogogue effect does not make any difference to the course of anaesthesia. However, if the antisialogogue action is important, glycopyrronium offers an advantage over atropine.

Adult↗

PubMed1976

Coronary artery spasm: the effect of cardiovascular laboratory premedication practice.

Eighty-four university cardiovascular laboratories responded to a questionnaire concerning premedication practice and observation of noncatheter-induced coronary artery spasm during routine coronary angiography. Half of the laboratories stated that they had not observed the phenomenon. The data suggest that premedication practice may account in part for the relative rarity of this phenomenon.

Angiography↗

PubMed1992

Naproxen premedication reduces postoperative tubal ligation pain.

This study evaluated the effectiveness of naproxen sodium oral premedication in reducing postoperative pain, analgesic requirements and day surgery length of stay in patients undergoing outpatient laparoscopic tubal ligations. We undertook a randomized, double-blind clinical trial on ASA I and ASA II patients undergoing outpatient laparoscopic tubal ligations. The treatment group received two capsules containing naproxen sodium, 275 mg each, and the control group received two identical capsules containing placebo. Postoperative visual analogue pain scores, analgesic requirements, side-effects and length of day surgery stay were studied. Forty-four patients completed the study with 21 patients in the naproxen group and 23 in the placebo group. There was a statistically significant difference between groups in terms of pain score (naproxen group 0.9 +/- 0.2 vs placebo group 3.5 +/- 0.6); patients requiring postoperative opioids (naproxen group 0% vs placebo group 34.8%); and time spent in the day surgery unit (naproxen group 168 +/- 13 min vs placebo group 188 +/- 15 min). There was no difference in the incidence of nausea and vomiting. Only one person developed a side-effect from the naproxen sodium which was minor gastric discomfort. This study shows that naproxen decreased the postoperative tubal ligation pain with less subsequent postoperative analgesic requirements, less time to street fitness and no increase in analgesic side-effects. We recommend the use of this premedication in outpatient laparoscopic tubal ligations.

Administration, Oral↗

PubMed1978

The effects of fiberoptic bronchoscopy with and without atropine premedication on pulmonary function in humans.

Pulmonary function studies, including arterial blood gas analysis, were performed in 21 patients undergoing fiberoptic bronchoscopy. Eight received premedication with atropine and 13 did not. In the atropine-treated group there was no significant deterioration in pulmonary function immediately after bronchoscopy compared with baseline. Compared with the values obtained after topical lidocaine anesthesia, however, there was a decrease in peak expiratory flow rate (PEFR) (20 +/- 20%), forced expiratory volume in one second (FEV1.0) (11 +/- 12%), forced expiratory flow between 25 and 75% of vital capacity (FEF25-75) (22 +/- 16%), and forced expiratory flow at 75% of exhaled vital capacity (FEF75) (28 +/- 38%) and an increase in residual volume (RV) (16 +/- 19%). In the no-atropine group, postbronchoscopy values showed a decrease in PEFR (13 +/- 19%), forced vital capacity (FVC) (13 +/- )9%), FEV1.0 (14 +/- 16%), and oxygen partial pressure (Pa02) (11 +/- 9%) and an increase in RV (19 +/- 31%) and alveolar-arterial oxygen pressure gradient (deltaAaPO2) (91 +/- 129%) compared with baseline values. In this group also, topical lidocaine anesthesia resulted in a decrease in FVC compared with baseline. We conclude that the deleterious effect of bronchoscopy on pulmonary function is counterbalanced by the beneficial effect of atropine and that atropine is therefore a useful premedication for fiberoptic bronchoscopy.

Adolescent↗

PubMed1978

[Cardiac side-effects of oesophago-gastro-duodenoscopy in relation to premedication (author's transl)].

The electrocardiogram was monitored in 100 patients undergoing oesphago-gastro-duodenoscopy. Premedication differed: 25 patients each were given either (Group I) atropine 0.5 mg, hyoscine-N-butylbromide 20 mg, and diazepam 5 mg, or (Group II) hyoscine-N-butyl-bromide 20 mg and diazepam 5 mg, or (Group II) diazepam 5 mg and glucagon 0.2 mg, or (Group IV) only diazepam 5 mg intravenously. After injection of the parasympatholytic drugs (Groups I and II) there was a significantly higher heart rate duringthe entire length of the examination than in groups III and IV. Nine of the ten cases of ascending S-T depression were found in Groups I and II, while descending (ischaemic) S-T changes occurred equally frequently in patients of all four groups. Two of the three more serious arrhythmias were registered after atropine. Since parasympatholytic drugs fail to inhibit arrhythmias and ST-T changes, while accentuating the rise in heart rate, it is recommended that premedication for oesophago-gastro-duodenoscopy should not include such drugs.

Adolescent↗

PubMed1978

Some predictive implications of premedical scientific competence and preferences.

Current medical school admissions criteria favor candidates with superior scientific aptitude and strong interests in scientific subjects. Four measures of this cluster were studied: Medical College Admission Test Science subtest scores, premedical grades in scientific subjects, preference for scientific subjects, and an equally weighted composite of these three. In a sample of 1,135 medical school graduates the four predictors were moderately related to academic performance in the first two years of medical school but almost completely unrelated to performance in the fourth year and to faculty ratings of general and clinical competence. The scientifically oriented graduates tended to enter specialties such as anesthesiology, pathology, and surgery, whereas graduates ranking lower on the overall index showed a slight tendency to prefer internal medicine, pediatrics, and psychiatry. Ratings and adjectival descriptions of premedical students with above average scores on the four measures revealed them to be narrower in interests, less adaptable, less articulate, and less comfortable in interpersonal relationships than their lower scoring peers.

California↗

PubMed1979

[The effect of premedication with thalamonal on the plasma catecholamine levels (author's transl)].

The sympathetic suppressant properties of Thalamonal as a premedication is reported in both normotensive and hypertensive patients. The investigations were carried out in 27 patients altogether, of whom 7 were previously treated hypertensives. The plasma catecholamines noradrenaline and adrenaline, the blood pressure and heart rate were monitored before and after premedication.

Blood Pressure↗

PubMed1975

[Chlorprothixene for premedication in children: oral versus intramuscular route (author's transl)].

The effect of chlorprothixene (Taractan), a neuroleptic agent, administered either intramuscularly (1 mg/kg) or orally as a 4% solution (1,5-2 mg/kg), was compared in a double-blind study in 200 children between 11 months and 10 years of age. In addition, intramuscular 1-hyoscyamine (Bellafolin) was given to all patients 30 minutes before the induction of anaesthesia (0.005-0.01 mg/kg). With regard to antisalivary action, suppression of reflex irritability, frequency of post-anaesthetic vomiting, postoperative sedation and requirement of postoperative analgesics, there was no significant difference between the two methods. Preoperative sedation was slightly more pronounced with the intramuscular technique. An undesirable side-effect, hypotension, was observed more often after intramuscular than oral premedication. To obtain optimum effect, an interval of 2 hours between the oral premedication and induction of anaesthesia is recommended.

Anesthesia↗

PubMed1976

[Premedication with valoron (Tilidin) in internal laparoscopy].

Apart from sufficient experience on the part of the examining physician and adequate technical apparatus, proper premedication can facilitate the procedures for both patient and physician considerably. The paper reports on experience gained in 500 laparoscopies carried out under conditions which were deviated slightly from those hitherto recommended in the literature. The analgesic employed was Tilidine (in Germany: Valoron), and Diazepam was used as a sedative; both of these substances were given intravenously, the vein was kept open for the entire course of the examination. The Tilidine dose was normally 50-100 mg, but under exceptional circumstances as much as 150 mg. Tilidine showed good analgesic effectiveness and tolerance; no case or nausea or vomiting and no sign of respiratory depression of effects on smooth muscle were observed under the conditions stated. The fact that Tilidine is not subject to the restrictions imposed by the German narcotics law is also seen as an advantage. The Diazepam dose was 5-30 mg. Apart from its sedative effect Diazepam also diminishes the tonus of skeletal muscle (important in laparoscopy) and has a relatively long time of elimination (20-48 h). In addition to these two substances, 10-20 ccm of 1% Lidocaine solution with Epinephrine additive was given as a local anaesthetic. The investigators' experience with the above premedication procedure was found to be convincingly positive.

Anesthesia, Local↗

PubMedDate not supplied

Antivenom use in Australia. Premedication, adverse reactions and the use of venom detection kits.

OBJECTIVES: To analyse reports of antivenom use and sequelae in Australia from July 1 1989 to June 30 1990. The value of snake venom detection kits (VDKs) was also analysed. METHODS: Information was obtained from antivenom usage reports returned to the Commonwealth Serum Laboratories and from personal letters sent to those reporting doctors. Information on VDKs was obtained from antivenom usage reports or from questionnaires packaged with VDKs. RESULTS: Reported antivenoms used were: red-back spider, 258 cases; funnel-web spider, 3 cases; stonefish, 26 cases; box jellyfish, 6 cases; snake, 91 cases. Immediate reactions followed administration of red-back spider antivenom in only two patients and snake antivenoms in four patients. Delayed reactions (serum sickness) followed use of red-back spider antivenom in three patients, stonefish antivenom in two, and snake antivenoms in three. No reaction was life-threatening. Premedication was used in the majority of red-back spider bites and in 66 of 86 snake bites. Oral corticosteroids were given prophylactically after some uses of snake antivenom to prevent serum sickness. VDKs were used in 181 cases of snake bite and were reported as being useful in selecting appropriate snake antivenom in 31% of cases of antivenom use. (Only 10 of these 181 were also reported on the antivenom usage report.) Appropriate first aid was given in 61% of cases. There were 50% fewer snake bites reported than 10 years ago. CONCLUSIONS: Antivenoms in Australia are well tolerated with few immediate or delayed reactions. The use of premedication and prophylactic oral corticosteroids for four to five days after antivenom administration may be responsible for this low reaction rate. VDK results help select the appropriate antivenom; however, in some cases positive results were obtained from urine samples from patients with no symptoms of envenomation.

Adolescent↗

PubMed1978

[Evaluation of Faustan (diazepam) in the premedication of ambulatory stomatologic-surgical interventions].

The author presents the results obtained with Faustan (diazepam) in the premedication of ambulatory stomatological interventions at a university clinic of stomatology. Experience was acquired in particular with intravenous premedication in a climical study involving 340 patients. The findings from this study and the experience with hundreds of ambulatory interventions in the past several years characterize Faustan, on condition of individual dosage, as a premedicant that is well suited for stomatological interventions, does not impair vital functions, increases the patients' willingness to co-operate and is of considerable anxiolytic activity. The use of Faustan is recommended for stomatological emergency situations and risk patients.

Ambulatory Care↗

PubMed1979

Dixyrazine (Esucos) as premedication for esophagogastroscopy. A controlled double-blind trial.

Dixyrazine (Esucos) as premedication for esophagogastroscopy was studied in a double-blind trial with diazepam and atropine in 321 successive endoscopies. It was established that dixyrazine was fairly well tolerated, regurgitation was significantly reduced. A distinct antiemetic effect was observed compared with diazepam; the difference was statistically significant in the male patients. Dixyrazine may be regarded as a fairly good alternative premedication for esophagogastroscopy.

Adult↗

PubMed1979

[Characteristics of combined nitrous oxide nacrosis and premedication with phentanyl and droperidol or phentanyl and seduxen in patients with pain syndrome caused by blood vessel diseases of the lower extremities].

66 patients were subjected to nitrous oxide narcosis after various types of premedication. The premedication with phentanyl and seduxen or droperidol proved to be more effective than the routine premidication. The authors consider endotracheal narcosis with nitrous oxide combined with fractional injections of phentanyl and seduxen of phentanyl and droperidol to be a method of choice.

Adult↗

PubMedDate not supplied

Changes in pharmacodynamics and pharmacokinetics of psycholeptic drugs in the course of radiation disease. Effects of premedication with cystamine on dynamics and kinetics of thioridazine.

Changes in pharmacodynamics and pharmacokinetics of psycholeptic drugs in the course of radiation disease. Effect of premedication with cystamine on dynamics and kinetics of thioridazine. Acta Physiol. Pol. 1977, 28 (2): 169--179. The effect of premedication with cystamine (100 mg/kg) applied before irradiation (600 R) on exploring mobility and cataleptic action of thioridazine was investigated in rats. The levels of thioridazine in blood serum, brain tissue and in bile were determined. It was found that cystamine prevents the changes in dynamics of thioridazine action in radiation disease through abolition of disturbances in kinetics of this drug. Half-life period of thioridazine was found to be reduced and its level in the brain tissue was diminished in the irradiated, cystamine-pretreated animals in comparison with the irradiated, untreated ones.

Animals↗

PubMed1976

[Problems of premedication in pediatric gynecologic consultation hours].

It is reported about the behavior of 300 children, which were examined and treated gynecological after premedication, which was performed with Elroguil, Faustan, Lepinal, Myocuran, Sinophebin liqu. The sedative effect was not good in all cases. A premedication is not generally indicated, but in some of the cases the situation of examination is better.

Adolescent↗

PubMedDate not supplied

Effect of esmolol on hemodynamics and intraocular pressure response to succinylcholine and intubation following low-dose alfentanil premedication.

STUDY OBJECTIVE: To determine the effectiveness of esmolol hydrochloride (Brevibloc) as an additional adjunct to low-dose alfentanil premedication in controlling the hemodynamic response [heart rate (HR), mean arterial pressure (MAP), and intraocular pressure (IOP)] to succinylcholine and endotracheal intubation. DESIGN: Randomized, double-blind, placebo-controlled, prospective study. SETTING: Ambulatory gynecologic surgery at a university medical center. PATIENTS: Twenty ASA physical status I and II female patients scheduled for outpatient laparoscopy under general anesthesia. INTERVENTIONS: All patients received alfentanil 10 micrograms/kg as a preoperative medication 4 minutes prior to induction of anesthesia. Study patients (n = 10 in each group) received either esmolol 1.5 mg/kg or a placebo (normal saline) 30 seconds prior to induction (210 seconds after alfentanil and 90 seconds prior to endotracheal intubation). Anesthesia was induced with thiopental sodium 5 mg/kg and succinylcholine 1 mg/kg. Postintubation, 70% nitrous oxide, 30% oxygen, and 1% isoflurane were administered. MEASUREMENTS AND MAIN RESULTS: Time of study drug administration was defined as time zero. Measurements of HR, MAP, and IOP were made at baseline (patient awake) and at each minute from minutes 1 through 6 after administration of the study drug (time zero). Analysis of variance was used to analyze the data, with a value of p less than 0.05 considered significant. Esmolol 1.5 mg/kg was found to blunt the maximum increase in HR but not MAP or IOP following low-dose alfentanil premedication. CONCLUSIONS: In an eye patient with coronary artery disease, or in any patient in whom tachycardia may be detrimental, esmolol may be a useful adjunct in combination with low-dose alfentanil to attenuate the increase in HR due to laryngoscopy and endotracheal intubation.

Adrenergic beta-Antagonists↗

PubMed1977

Nitrazepam premedication for minor surgery.

Sixty-one patients received nitrazepam 5 mg by mouth on the night before operation, followed by 2.5 mg given on the morning of operation and were compared with 60 patients who received no premedication. All were undergoing either therapeutic abortion, by dilatation and curettage, or explorative curettage. The plasma concentrations of nitrazepam were determined by gas chromatography and compared with the clinical effects of the drug. The premedicated patients slept better on the night before operation, and were more sedated and less apprehensive. Headache was more frequent following nitrazepam. There was no significant difference between the groups in respect of dizziness and nausea. The unpremedicated patients had a faster average heart rate. There was no obvious relationship between the plasma concentration of nitrazepam and the quality of sleep, degree of sedation, apprehension, excitement or headache.

Administration, Oral↗

PubMed1978

Comparative study of two long-acting tranquillizers for oral premedication.

Lorazepam 2.5 mg was compared with promethazine 50 mg as oral premedication in a double-blind study in women. The premedication was given at the same time to all patients on each operating list, and both drugs continued to be effective 6 h after ingestion. A similar number of patients considered each drug to have relieved anxiety and the amnesic effect of lorazepam was confirmed. However, the use of lorazepam alone was accompanied by significantly more salivation during and after anaesthesia than the use of promethazine, especially in patients in whom the trachea was intubated. There was also a higher frequency of vomiting during and after operation with lorazepam (seven of 67 patients) than after promethazine (one of 71 patients). Promethazine produced dyskinetic side-effects in six of 71 patients.

Administration, Oral↗