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Premedication

This article outlines the essential role of premedication in anesthesia, as presented by Dr. M. Kannan, MD, DA, Professor and HOD of Anaesthesiology at Tirunelveli Medical College. Premedication is crucial for reducing patient anxiety, secretions, and postoperative complications, while enhancing the hypnotic effects of anesthetics. A comprehensive approach to premedication involves the use of anxiolytics, anticholinergic drugs, and antiemetics. It also offers guidelines on drug selection based on specific patient conditions and the importance of individualized care.

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Premedication

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  1. Premedication Dr.M.Kannan MD DA Professor And HOD Department of Anaesthesiology Tirunelveli Medical College

  2. Premedication • Drugs administer 1-2 hours before induction of Anaesthesia

  3. Why Premedication • To Allay anxiety and fear • Non Pharmacological -Assurance &Raport • Pharmacological -Benzodiazepanies -Diazepam -Medazolam -Lorozepam

  4. Why Premedication • To Reduce Secretion • Salivary secretion • Broncheal secretion • Anticholinergic drug-Atropine -Glycopyrolate Tachycardia Hyperthermia

  5. Why Premedication • Enhances Hypnotic effect of General Anaesthetic Drugs -Less amount volatile Anaesthetics and nacotics

  6. Why Premedication • Reduces Postoperative Nausea and Vomiting • Aspiration • Psychological trauma

  7. To Prevent Vomiting • Metachlorpropamide • Ondansetron • Ranitidine

  8. Why Premedication • Produce Amnesia • Benzodiazepine group -Diazepam 0.1-0.2mg/kg -Medazolam0.05mg/kg -Lorozepam

  9. Why Premedication • Gastric Content Volume ph -alkaline • Metoclopramide- • Sodium citrate

  10. Why Premedication • Attenuate sympathetoadrenal response -Laryngoscopy

  11. Why Premedication • Attenuate vagal reflex • ? Bradycardia • Traction of eye muscle in squint surgery • Repeated administration succinylcholine -Induction of Anaesthesia with halothane -Lighter plane of Anaethsia

  12. Why Premedication • Allay anxiety and fear • Reduce Secretion • Enhances Hypnotic effect of General Anaesthetic Drugs • Reduces Postoperative Nausea and Vomiting • Produce Amnesia • Gastric Content Volume ph -alkaline • Attenuate vagal reflex • Attenuate sympathetoadrenal response

  13. What Drugs ? • Antisailagoge –Atropine/Glycopyrolate • Sedative –Morphine -Pethedine -Benzodiazepaines -Barbiturates Antiemitics -Metachlorpropamide/Ondonsetron • Disease Specific Drugs

  14. Can we Give Fixed Pre.Med NO Cardiac –Avoid anticholinergics & Stiff sedatives Thyrotoxicosis- Avoid anticholinergic Head injury- Avoid sedatives Airway obstruction- Aviod sedatives Pregnancy- Avoid sedatives

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