Dr . S. Parthasarathy MD., DA., DNB, MD ( Acu ), Dip. Diab . DCA, Dip. Software statistics PhD ( physio ) Mahatma Gandhi medical college and research institute – Puducherry – India . Premedication . Sedation and anxiolysis Analgesia and amnesia Antisialagogue effect
Analgesia and amnesia
To maintain hemodynamic stability, including decrease in autonomic response
To prevent and/or minimize the impact of aspiration
To decrease postoperative nausea and vomiting
Prophylaxis against allergic reaction
VAAAAAS--Why we need ??
Oral doses of 40 to 80 mg must be given 2 to 4 hours before surgery to be effective
Other PPIs – usedOmeprazole
Many anesthesiologists prefer not to administer antiemetics as part of a preoperative regimen, but believe that antiemetics should be administered intravenously just before they are needed at the conclusion of surgery.
Droperidol, metoclopramide, ondansetron, and dexamethasoneAt the end ?? Antiemesis
MethadoneThey are not premedicants in strict sense but we use
consider treatment in any patient who has received corticosteroid therapy for at least 1 month in the past 6 to 12 months.
80 mg 6 hourly
300 mg / day – maximal daily production to stressSteroids
Intranasal dexmedetomidine produces more sedation than oral midazolam when children were separated from their parents and at induction of anesthesiaDexmed premed
Nasal transmucosalketamine at a dose of 6 mg/kg is also effective in sedating children within 20 to 40 minutes before induction of anesthesia.
Oral ketamine, IM ketamine , IV ketamineKetamine