Anaesthesia for Adenotonsillectomy a Critical Approach

Doughty, Andrew

doi:10.1097/00132586-195810000-00013

Cited by 2 publications

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“…Dosage D. Papaveretum 3.3 mg/stone is the strongest of tie four. It approximates to that originally recommended by Anderson (1951) and modified by Doughty (1957) who described it as "1 minim of standard solution per 5 lb. body weight".…”

Section: Methodsmentioning

confidence: 51%

“…Papaveretum-hyoscine was popularized as a premedication for children by Anderson (1951) who pointed out that, contrary to current opinion, children were particularly tolerant of opiates and proposed a dosage scheme roughly twice as great as that normally used for adults. Although Anderson did not recommend the mixture as a premedication before adenotonsillectomy other authors have suggested its use before this operation (Ballantine and Jackson, 1955;Doughty, 1957). Advantages claimed are the ready acceptance of an intravenous induction, reduction of postoperative resdessness and some degree of amnesia.…”

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confidence: 99%

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Premedication of Children With Papaveretum-Hyoscine

Davies

Doughty

1967

British Journal of Anaesthesia

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Papaveretum-hyoscine is a popular premedication for children but there is no agreement as to dosage. Four dosage schemes were compared in a double blind trial on children undergoing adenotonsillectomy in an attempt to determine the optimum method of using the drug mixture. No real difference in behaviour and cooperation in the anaesthetic room could be detected between any of the dosage schemes. The highest dosage is associated with excessive salivary suppression, increase in violent restlessness, postoperative vomiting and respiratory depression. One instance is reported of a near fatality due to respiratory depression following the postoperative opiate. The only advantage of the highest dosage is some increase of amnesia for the intravenous induction. For these reasons the lowest of the four dosage schemes used in the trial is recommended, namely, 2 mg/stone of papaveretum (with 0.04 mg/stone of hyoscine). This can be regarded as the normal adult dose scaled down in proportion to the weight of the child, and there is little justification for the use of stronger dosages as premedication for children.

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Section: Methodsmentioning

confidence: 51%

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confidence: 99%

Premedication of Children With Papaveretum-Hyoscine

Davies

Doughty

1967

British Journal of Anaesthesia

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“…It will be seen from table X that the majority of children in all four groups were recorded as "Moderately Restless", the degree which the sister considered in her experience to be normal. None of the premedications appeared to be associated with postoperative sedation of a degree similar to that noted after papaveretum-hyoscine in a previous trial (Doughty, 1959), nor was there a marked tendency to undue hyper-excitability such as might be expected after a barbiturate premedication, although one can discern a small but significant difference between pecazine-hyoscine and trimeprazine-hyoscine if the figures are analyzed simply as "Not Restless/Restless". This is in keeping with the findings of Dundee (1961) who reported that pecazine, in contrast to trimeprazine, has a marked anti-analgesic effect.…”

Section: Postoperative Observationsmentioning

confidence: 55%

“…In a previous communication, a method of assessing behaviour in relation to premedication was described (Doughty, 1959). The children were subjected to three tests: firstly, their demeanour in the anaesthetic room as they faced the prospect of an intravenous injection; secondly, their response to the experience of the injection and thirdly, whether or not they were able to hold their hands still after the injection.…”

Section: Demeanour In the Anaesthetic Room (Table Iii)mentioning

confidence: 99%

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Oral Premedication in Children

Doughty

1962

British Journal of Anaesthesia

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In view of the current interest in the subject of oral premedication in children it seemed desirable to stage a blind controlled clinical trial of drugs recently recommended by various authors. Pecazine has been recommended by Corssen and Allen (1958) and by Green (1959); trimeprazine by Cope and Glover (1959) and by Gunner and Fox (1960); and methylpentynol by Rendell (1954), Gusterson (1955) and by Kelsall (1957). In this trial the drugs were ordered to be administered 1 hour before operation in accordance with the dosage given in table I. As a salivary suppressant, hyoscine hydrobromide was mixed with each of the sedative drugs and, to provide a control, a blank solution containing hyoscine-only was used. The effects of the four premedications were studied on 480 children aged 2 to 12 undergoing adenotonsillectomy or other minor nose and throat surgery. The premedications were allocated at random and the bottles containing the drug solutions were labelled with code letters which were changed five rimes during the trial. The identification of the code was known only to the hospital pharmacist. The method of anaesthesia was intravenous thiopentone 50 mg/stone (7.9 mg/kg), suxamethonium, oral intubation, nitrous oxide, oxygen and halothane 1 per cent. Each child was seen personally by the writer on the evening before operation, the method of induction of anaesthesia explained to him and a promise elicited to hold the hand quite still during venepuncrure. All the anaesthetics were given by the author. Palatability of premedication (table II). The solutions were flavoured with a sweet syrup and oil of peppermint. The latter was added primarily in an attempt to disguise the charac-80

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Anaesthesia for Adenotonsillectomy a Critical Approach

Cited by 2 publications

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Premedication of Children With Papaveretum-Hyoscine

Premedication of Children With Papaveretum-Hyoscine

Oral Premedication in Children

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