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
Click Here to Start Quiz
Click Here to Start Quiz