16: Preoperative Medication

CHAPTER 16 Preoperative Medication



Sunil Kumar, MD, FFARCS



1 List the major goals of premedication


Premedication needs to be tailored to the needs of individual patient. Important goals include:


image Sedation and anxiolysis

image Analgesia and amnesia

image Antisialagogue effect

image To maintain hemodynamic stability, including decrease in autonomic response

image To prevent and/or minimize the impact of aspiration

image To decrease postoperative nausea and vomiting

image Prophylaxis against allergic reaction


2 List the most commonly used preoperative medications with the appropriate dose


See Table 16-1.



TABLE 16-1 Common Preoperative Medications, Dosage, and Route*

image


3 What factors should be considered in selecting premedication for a patient?



image Patient age and weight

image Physical status

image Levels of anxiety and pain

image Previous history of drug use or abuse

image History of postoperative nausea, vomiting or motion sickness

image Drug allergies

image Elective or emergency surgery

image Inpatient or outpatient status


4 What factors limit the ability to give depressant medications preoperatively?



image Extremes of age

image Head injuries or altered mental status

image Limited cardiac or pulmonary reserve

image Hypovolemia

image Full stomach


5 What is meant by psychologic premedication?


Most patients are very anxious before surgery. An informative and comforting visit by an anesthesiologist may replace many milligrams of depressant medication and acts as psychologic premedication. During this visit a full description of the planned anesthetic events to anticipate in the perioperative period should be provided to the patient and family members, and all questions the patient or family may have should be answered. However, psychologic preparation cannot accomplish everything and will not relieve all anxiety.



6 Discuss the role of benzodiazepines in premedication

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May 31, 2016 | Posted by in ANESTHESIA | Comments Off on 16: Preoperative Medication

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