Premedication Practices Research Articles

Preanaesthetic Medication: A Survey of Current Usage

A survey has been carried out amongst the UK based members of the Association of Anaesthetists of Great Britain and Ireland regarding their practice of premedication. Ninety-three per cent of respondents (reply rate 51.7%) used sedative-hypnotic premedication routinely in adults and 84% in children. However, anticholinergic premedication was used by only 36% in adults and 56% in children. Temazepam was the most frequently used sedative premedicant in adults and trimeprazine in children. Atropine and hyoscine were the most frequently used anticholinergic drugs. The main reasons for using sedative-hypnotic premedication were allaying anxiety and providing sedation. The main reasons for using anticholinergic drugs were drying of secretions and protection against vagal overactivity. This survey concludes that while sedative-hypnotic premedication continues to be used in the majority of patients with oral benzodiazepines the most frequently used drugs, the use of anti-cholinergic premedication continues to decline.

UNTOWARD REACTIONS TO CURARE CONSEQUENT TO VAGAL HYPERACTIVITY FOLLOWING ELECTROSHOCK CONVULSIONS

AT TIMES it is necessary to diminish the violence of convulsions induced in the treatment of mental diseases; this has led in some instances to the practice of premedication with curare, in the form of intocostrin. While this procedure has been employed successfully many times, its use creates certain hazards not ordinarily associated with convulsant therapy. The commonly recognized untoward manifestation associated with curarization is respiratory paralysis. This appears to be of two types, consequent either (a) to severe generalized muscular weakness, which may be overcome rapidly with neostigmine methylsulfate, or (b) to central depression of respiration, as noted by Fegler.1The latter type may be associated with no unusual weakness of skeletal muscle2and is not noticeably benefited by neostigmine.3These reactions, though hazardous, are amenable to rational therapy and become dangerous largely through lack of preparedness for their occurrence. Still another type of accident has,