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At least 19 recordsLinked to original sources
PubMed1993

[Oral premedication with clorazepate dipotassium. Comparison with oral premedication with flunitrazepam and intramuscular premedication with promethazine, pethidine and atropine in adults].

UNLABELLED: The purpose of premedication and the best form have been frequent subjects of controversy among anaesthetists in the past few years. Anxiolysis is now accepted as the main purpose. The preferred route of administration is by mouth. The intention of this study was to examine whether clorazepate dipotassium has the same sedative-hypnotic and anxiolytic effects as i.m. premedication with promethazine, pethidine and atropine. METHODS: A total of 100 patients aged 20-65 years and due to undergo arthroscopy took part in this study. Patients in group I were given 1 mg flunitrazepam p.o. on the evening before the operation and the i.m. premedication described above. The premedication for group II consisted in clorazepate dipotassium, 50 mg on the evening before operation and 25 mg on the morning of the day of the operation. The sedative-hypnotic effects were measured on a four-point scale. The Erlangen anxiety scale (EAS) and a visual analogue scale (VAS) were used to evaluate the anxiolytic effects according to the patient's own and the observer's evaluation of mood. In addition to this, we measured amnesia, heart rate and blood pressure. RESULTS: Clorazepate dipotassium or flunitrazepam p.o. significantly reduces anxiety 1 h after administration as measured by the EAS (P < 0.05) on the evening before the operation. This result was not, however, confirmed by the VAS for self-assessment. Patients who received premedication with clorazepate dipotassium are less anxious on the morning of the operation than patients given flunitrazepam the evening before the operation (P < 0.05); this, however, does not correspond to the VAS results. There were no differences in the other parameters compared. DISCUSSION: Oral premedication with clorazepate dipotassium has the same sedative-hypnotic, anxiolytic and amnestic effects as i.m. premedication with promethazine, pethidine and atropine. The results of this study are better than those obtained by Tolksdorf et al., owing to the higher dosage used in our study (50 mg as against 20 mg). Tolksdorf et al. [21] failed to show any improvement on a placebo. Our results correspond to those of Drautz et al. [2] who used 50 mg of clorazepate dipotassium on the evening before and 25 mg on the morning of the day of the operation.

Administration, Oral↗
PubMed2000

Premedication for anxiety in adult day surgery.

BACKGROUND: Surgery is increasingly performed on a day-case basis. Many patients are anxious pre-operatively and might benefit from pharmacological anxiolysis. Drugs are sometimes not used, however, for fear of delaying discharge from hospital. OBJECTIVES: To asses the effect of anxiolytic premedication on time to discharge in adult patients undergoing day case surgery under general anaesthesia. SEARCH STRATEGY: Trials were identified by computerised searches of the Cochrane Controlled Trials Register, MEDLINE, EMBASE, by checking the reference lists of trials and review articles, by hand-searching three main anaesthesia journals and by contacting five researchers active in the field and the Product Information departments of the manufacturers of five commonly used premedicants. SELECTION CRITERIA: All randomised controlled trials comparing an anxiolytic drug(s) with placebo before general anaesthesia in adult day case surgical patients. DATA COLLECTION AND ANALYSIS: We collected data on anaesthetic drugs used, results of tests of psychomotor function where these were used to assess residual effect of premedication, and on times from end of anaesthesia to ability to walk unaided or readiness for discharge from hospital. Formal statistical synthesis of individual trials was not performed in view of the variety of drugs studied. MAIN RESULTS: Searching identified twenty-nine reports; fourteen studies, with data from a total of 1263 patients, were considered eligible for analysis. Only two studies specifically addressed the discharge question; both found no delay in premedicated patients. Three other studies used clinical criteria to assess fitness for discharge, though times were not given. Again, there was no difference from placebo. Four studies used both clinical measures and tests of psychomotor function as tests of recovery from anaesthesia. In none of these studies did the premedication appear to delay discharge, although performance on tests of psychomotor function was sometimes still impaired. Of the four studies which used tests of psychomotor function to assess recovery, three showed impaired recovery (after midazolam 7.5mg, midazolam 15mg or diazepam 15mg) which might possibly interfere with discharge from hospital. REVIEWER'S CONCLUSIONS: We have found no evidence of a difference in time to discharge from hospital in patients who received anxiolytic premedication. However, in view of the age and variety of anaesthetic techniques used, inferences for current day-case practice should be made with caution.

Adult↗
PubMed1964

THE PREMEDICAL STUDENT: HIS IDENTITY. CHARACTERISTICS OF A COHORT OF PREMEDICAL STUDENTS AT THE UNIVERSITY OF BRITISH COLUMBIA.

A prospective study is currently being conducted of students who were freshmen at the University of British Columbia in 1961-1962. Three cohorts are being followed: 136 premedical students, 107 science students, and 136 persons comprising a sample of general arts students. At registration in 1961, the only demographic difference was that the Premedical cohort had a greater proportion of catholics and persons from upper occupational classes. Premedical students generally performed as well in high school as science students and better than general arts students, though the academic potential of science students as measured by achievement and aptitude tests was superior. Premedical students performed better on freshman examinations than the other cohorts, though a significantly larger proportion of science students (84.4%) actually passed into second year than of premedical students (75.0%). A disturbing observation was that by second year the Science cohort had recruited more than enough students to balance its losses, while the Premedical cohort had lost three times as many students as it recruited. The net effect was not much reduced by students who entered directly from senior matriculation or other universities, since these students were about twice as likely to enter the Science cohort as they were to enter the Premedical cohort.

Achievement↗
PubMed1986

Premedication administered to anesthesiologists as patients: their evaluations of its effect and its influence on premedication prescribing habits.

Inquiries were sent to practising Austrian anesthesiologists to ascertain their premedication-prescribing habits and their assessment of premedicants that they received as patients. The 143 replies received showed meperidine/promethazine (M/P) as most used n = 83 and received (n = 54) drug (combination), followed by fentanyl/droperidol (F/D) n = 33 (n = 21), benzodiazepines (BZ) n = 17 (n = 10) and several other drugs (combinations) n = 10 (n = 14). There was no significant difference in the premedication habits of the 82 anesthesiologists who had received premedication and those (61) who had no personal experience with premedicants. The former judged M/P to be significantly superior to F/D and other schemes; however there was no significant difference from the judgement of the BZ. Unpleasant side effects have been described in 9% of M/P, 10% of BZ, 24% of F/D and 21% of other premedicants. On future occasions 10% of BZ-, 13% of the M/P-, 24% F/D- and 21%-receivers of other combinations would reject the same drug. Seven F/D and five M/P users converted their prescription schemes after they had received the same drug for their own premedication. The prescription habits were not influenced by dependency on departmental or hospital orders. Of those who had received it 75% desired premedication and 25% accepted premedication, suggesting that anesthesiologists believe in the positive effects of premedication. However, the overall incidence of 10% unpleasant side effects, even in the better ranked drugs, shows that the available premedicants do not yet seem to be satisfactory.

Anesthesiology↗
PubMed1986

[Equivalence of oral and intramuscular premedication. II. Effect of various conventional premedication drugs].

In a randomised study, 6 different premedications (oral flunitrazepam, oral pentobarbital, oral physiological NaCl solution, intramuscular pethidine, intramuscular droperidol/fentanyl, intramuscular physiological NaCl solution) were administered to 600 patients to determine the equal efficacy of the premedicative drugs in oral or parenteral administration. Patients gave the best rating to the oral application of flunitrazepam. The differences in the assessment of application and effect of the drugs are contrasted by the statement that most patients do not feel any direct influence on their preoperative anxiety by premedication. However, it is easier for them to cope with anxiety because premedication pacifies the patients, whereas each of the dependent variables, such as apprehension, is influenced differently. Oral premedication again proves superior to parenteral premedication.

Administration, Oral↗
PubMed1965

THE PREMEDICAL STUDENT: HIS PROGRESS. A STUDY OF A COHORT OF PREMEDICAL STUDENTS AT THE UNIVERSITY OF BRITISH COLUMBIA.

Since September 1961, a prospective study of premedical and science students has been conducted at the University of British Columbia. On completion of their sophomore year, after a year of changes from one group to another or withdrawal from either group, only 82 students existed in the diminished Premedical cohort while 137 students existed in the augmented Science cohort. These two groups have now become similar demographically, and their academic potential, as indicated by achievement and ability tests, has also become similar in terms of their mean test scores. In academic performance the present Premedical cohort has displayed some superiority over the Science cohort in high school, freshman and sophomore years. The sophomore premedical mean grade was 66.0% compared with 63.7% for the Science cohort. The hypothesis is developed that these findings reflect a difference in motivation, and therefore that perception of ultimate career goals will motivate and affect academic performance of students in their undergraduate years.

Achievement↗
PubMed1999

[Adverse hemodynamic changes during laparoscopic cholecystectomy and their possible suppression with clonidine premedication. Comparison with intravenous and intramuscular premedication].

Laparoscopic cholecystectomies have adverse haemodynamic effects which limit their use in risk patients with heart disease. This applies in particular to significant hypertension. The etiology is analysed in detail in a review of the literature. The authors confirmed in their work involving 21 patients the incidence of these effects and tried to suppress them by premedication with clonidine (CATAPRESAN, Boehringer). 21 patients were given 0.15 mg clonidine in an infusion 15 minutes before operation and 21 patients 0.15 mg clonidine by the i.m. route 60-90 min. before operation. Standard anaesthesia was administered. A highly significant drop in the incidence of hypertension was recorded during operation for systolic pressure (p < 0.001) after both ways of administration, as well as of diastolic pressure (p < 0.01 for intravenous and p < 0.05 for intramuscular premedication). Premedication with intravenous clonidine can be recommended as a routine procedure before laparoscopic cholecystectomies.

Adrenergic alpha-Agonists↗
PubMed1986

[Equivalence of oral and intramuscular premedication. III. Effect of premedication on anesthesia and postoperative pain].

600 patients were given 6 different premedications in randomised design to study their effect on the course of anaesthesia and on postoperative pain. Premedication acts indirectly on anaesthesia, depending on the influence of the drug on anxiety and on the somatic correlates of anxiety. The greater the sedative-anxiolytic effect of the premedication, the easier it is to induce anaesthesia, and the more superficial the anaesthesia, resulting in earlier and stronger onset of postoperative pain. On the other hand, the more anxious the patient is, the more he consumes anaesthetic drugs, whereas anaesthesia remains superficial with the same consequences in respect of postoperative pain. In view of postoperative pain, fast and early awakening from anaesthesia must not be aimed at, particularly after operations which definitely result in postoperative pain (long-term operations in those regions of the body that cannot be immobilised).

Administration, Oral↗
PubMed1988

[Midazolam used for intramuscular premedication in locoregional anesthesia in urology. Usefulness of late premedication].

Midazolam was used as an intramuscular premedication combined with atropine in a population of 100 patients receiving loco-regional anaesthesia for urologic procedures. Two different dosages were given according to age: 0.10 mg/kg for patients over 50 years, 0.15 mg/kg for those under 50. This premedication was always effected just before the patient's transport to surgery. We observe the quality of anxiety relief (85%), sedation (82%), anterograde amnesia. These results confirm that midazolam is a suitable drug for late premedication by the intramuscular route. It is a potent drug with regular short-lasting action, which lead us to suggest its use in ambulatory anaesthesia.

Aged↗
PubMed1999

The plight of premedical education: myths and misperceptions--Part I: The "premedical syndrome".

The preparation for medical study and the process of gaining admission to medical school have long been contentious subjects, plagued by myths and misperceptions. In the first of two articles about the plight of premedical education, the author focuses on the myths of the "premedical syndrome" and the "cutthroat" medical student. He describes the origins of these myths, what purposes they may serve, why they persist, and why he believes they truly are myths and not accurate reflections of reality.

Competitive Behavior↗
PubMed1986

[Equivalence of oral and intramuscular premedication. I. Oral versus intramuscular premedication].

In a randomised study, 6 different premedications (oral flunitrazepam, oral pentobarbital, oral NaCl solution; intramuscular pethidine, intramuscular droperidol/fentanyl, and intramuscular NaCl solution) were administered to 600 patients, to determine the equal efficacy of oral and intramuscular application. The results show a significantly better mode of action of oral premedication.

Administration, Oral↗
PubMed1994

The effect of premedication on oxygen saturation during the post-premedication period in 20 Chinese children undergoing elective surgery.

Peri-operative continuous pulse oximetric data were studied in healthy Chinese children randomly allocated to receive either pethidine 1 mg kg-1 and atropine 0.02 mg kg-1 intramuscularly 90 min prior to surgery (n = 10), or midazolam 0.5 mg kg-1 and atropine 0.02 mg kg-1 orally, 120 min before surgery (n = 10). Data were collected during the night before surgery, after premedication and for 8 h post-operatively. The pulse oximeter (Nellcor N-200E) output was retrospectively evaluated using Satmaster, a computer programme which permits storage, retrieval, signal evaluation and compilation of oximetric data. There was no significant difference in the frequency, duration, or magnitude ofdesaturation episodes recorded during the post-premedication period compared to the desaturation episodes which occurred in the same child during normal sleep, on the night before surgery. Furthermore, there was no significant difference in the desaturation data between the two premedicant regimens. No child recorded a genuine desaturation less than 80% for longer than 15 s at any time during the study. Neither regimen significantly depressed saturation in otherwise healthy children presenting for minor surgical procedures.

Atropine↗