Preanesthetic Medication

PREANESTHETIC MEDICATION


Introduction:

Premedication/Preanaesthetic medication: 

  • Refers to drug usage before anesthesia to have pleasant & safe anesthetic experience.

Need for premedications:

  • Relief of anxiety & apprehension preoperatively.
  • Facilitate smooth induction.
  • Amnesia for preoperative & postoperative events.
  • Supplement & potentiate analgesic action of anesthetics.
  • Reduces anesthetic dose.
  • Decrease secretions & vagal stimulation to avoid undesirable reflex.
  • Prevention of post-operative nausea & vomiting.
  • Extendable antiemetic effect into post-operative period.
  • To decrease any chances of aspiration.
  • Decrease acidity & volume of gastric juice for reduced damage, if aspirated.
  • Note: For elective surgeries, hemoglobin should be at least 10 gm/dl or more.
Drugs used:

To relieve anxiety/as sedation:

  • Lorazepam – Most common.
  • Midazolam – For day care surgeries.
  • Diazepam

To decrease chances of aspiration: 

  • Patient fasting for solid – For 6 hrs.
  • Fasting for water – For 3-4 hrs.
  • Patient at high risk of aspiration (hiatus hernia, pregnancy) – Gastric prokinetics/antacid/H2 blockers.
  • H2 blocker/proton pump inhibitor – Ranitidine/famoditine, omeprazole/pantoprazole.

To control secretion:

  • Anticholinergics (Glycopyrrolate, atropine or scopolamine).
  • Glycopyrrolate – Preferred anticholinergic over atropine & scopolamine (hyoscine).
  • Glycopyrrolate does not cross blood-brain barrier & nil CNS side effects.

To prevent nausea & vomiting:

  • Hyoscine, ondansetron, metoclopramide or demperidone.
  • Hyoscine – Most potent antiemetic.

As Neuroleptics:

  • Haloperidol/chlorapromazine/triflupormazine.

Other drugs:

  • Opioids: Morphine/pethidine.

Exam Important

Premedication/Preanaesthetic medication – Need:

  • Relief of anxiety & apprehension preoperatively.
  • Facilitate smooth induction.
  • Amnesia for preoperative & postoperative events.
  • Supplement & potentiate analgesic action of anesthetics.
  • Reduces anesthetic dose.
  • Decrease secretions & vagal stimulation to avoid undesirable reflex.
  • Prevention of post-operative nausea & vomiting.
  • Extendable antiemetic effect into post-operative period.
  • To decrease any chances of aspiration.
  • Decrease acidity & volume of gastric juice for reduced damage, if aspirated.
Drugs used:

To relieve anxiety/as sedation:

  • Lorazepam – Most common.
  • Midazolam – For day care surgeries.
  • Diazepam

To decrease chances of aspiration: 

  • Patient fasting for solid – For 6 hrs.
  • Fasting for water – For 3-4 hrs.
  • Patient at high risk of aspiration (hiatus hernia, pregnancy) – Gastric prokinetics/antacid/H2 blockers.

To control secretion:

  • Anticholinergics (Glycopyrrolate, atropine or scopolamine).
  • Glycopyrrolate – Preferred anticholinergic over atropine & scopolamine (hyoscine).
  • Glycopyrrolate does not cross blood-brain barrier & nil CNS side effects.

To prevent nausea & vomiting:

  • Hyoscine – Most potent antiemetic.
Don’t Forget to Solve all the previous Year Question asked on PREANESTHETIC MEDICATION

Module Below Start Quiz

Leave a Reply

Free Mini Course on Stomach

Mini Course – Stomach

22 High Yield Topics in Stomach

in Just 2 Hours

Submission received, thank you!

Close Window
%d bloggers like this:
Malcare WordPress Security