Morphine, Scopolamine, and Atropine as Intravenous Surgical Premedicants

Jt, Conner; Jw, Bellville; Wender, Ronald H.; Schehl, D.; Dorey, Fred; Rl, Katz

doi:10.1213/00000539-197709000-00002

Cited by 9 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The observation of frequent side-effects during the postoperative course after morphine-scopolamine sedation is in agreement with earlier reports (9). Surpris-ingly, the high incidence of side-effects did not generally affect the patients' preference for method.…”

Section: Discussionsupporting

confidence: 92%

Comparison of Rectal Diazepam and Subcutaneous Morphine‐Scopolamine Administration for Outpatient Sedation in Minor Oral Surgery

Lundgren

1985

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

In a randomized cross-over study on sedation in outpatient oral surgery, subcutaneous administration of morphine-scopolamine was compared with rectal administration of diazepam. The mean dose of morphine was 0.13 mg kg-1 (range 0.13-0.24) and of diazepam 0.57 mg kg-1 (range 0.50-0.71). Apprehension, the determining factor for patients' preference for sedation method, the recovery from sedation and the postoperative course were studied. Both methods produced the desired effects. For diazepam, the effect was scored higher by the patient than the nurse observer and for morphine-scopolamine the opposite was found. Postoperative pain and patients' preference for sedation did not differ between the methods and the determining factor for the patients' preference for sedation method was the experience of stronger tranquilization. Side-effects such as prolonged recovery, nausea, dizziness, and dysphoria were frequent during the postoperative course after the morphine-scopolamine sedation but were not seen during diazepam sedation. Thus, rectal administration of diazepam should be preferred to morphine and scopolamine for sedation in minor oral surgery performed under local anesthesia.

show abstract

Section: Discussionsupporting

confidence: 92%

Comparison of Rectal Diazepam and Subcutaneous Morphine‐Scopolamine Administration for Outpatient Sedation in Minor Oral Surgery

Lundgren

1985

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…Patient acceptance of droperidol 5.0 mg with either fentanyl or morphine was no better than combinations with droperidol 2.5 mg or even fentanyl or morphine alone. While the raw relief of anxiety and sedation scores seen in this study are high and comparable with those obtained with other drug combinations we have studied with the same method (Conner et al, 1976(Conner et al, , 1977a, the raw patient acceptances scores are poor. We recognize the inherent weakness of comparing drugs across studies.…”

Section: Discussionsupporting

confidence: 82%

Droperidol, Fentanyl and Morphine for I.V. Surgical Premedication

Conner¹,

Herr²,

Katz³

et al. 1978

British Journal of Anaesthesia

View full text Add to dashboard Cite

Fentanyl 0.1 mg and morphine 10 mg alone and in combination with droperidol 2.5 and 5.0 mg were studied for i.v. surgical premedication in 240 patients. Relief of anxiety, sedation, lack of recall, patient acceptance and side-effects were evaluated. The addition of droperidol to fentanyl and morphine produced greater sedation and relief of anxiety before operation, but did not improve patient acceptance or lack of recall.

show abstract

“…A survey of the literature shows that in many central actions, scopolamine has about 10 times the activity of atropine, whereas the ratio for most peripheral actions is closer to 2 (Parkes, ). A similar ratio of relative potency has been found in young volunteers (Ketchum et al ., ), in children and adults during the induction of anaesthesia (Conner et al ., ; Root and Loveland, ), and in the treatment of the ‘death rattle’ in terminal care (Wildiers et al ., ).…”

Section: Introductionmentioning

confidence: 99%

Acute effects of a low‐dose atropine/scopolamine mixture as a food contaminant in human volunteers

Perharič

Juvan

Stanovnik

2012

J of Applied Toxicology

View full text Add to dashboard Cite

To verify the assumptions in our previous risk assessment of an atropine/scopolamine mixture in buckwheat flour, we performed a randomized, double-blind, placebo-controlled cross-over study in 20 healthy, adult volunteers. The volunteers ingested a traditional Slovenian buckwheat meal, made of boiled buckwheat flour to which alkaloids were added. In addition to the placebo they ingested 0.12/0.10, 0.37/0.29, 1.22/0.95, 3.58/2.81 and 12.10/9.50 µg kg(-1) body mass (BM) of the atropine/scopolamine mixture. The changes in body temperature, heart rate, salivary and sweat secretion, pupil size, near-point vision and subjective symptoms were recorded regularly for 4 h after the ingestion. Decreased salivary and sweat secretion, increased heart rate and pupil size and reduced near-point vision accompanied by characteristic subjective symptoms were observed at 12.10/9.50 µg kg(-1) BM. At doses of 0.37/0.29 and 1.22/0.95 µg kg(-1) BM, a significant decrease in the heart rate was noted, which we consider to be a critical effect of a low-dose exposure to the atropine/scopolamine mixture. Although this did not have any clinical relevance in our subjects, it may have serious implications if it occurred in people with pre-existent cardiac conditions or those on medications that may cause bradycardia. No significant changes in the observed end points were noted at 0.12/0.10 µg kg(-1) BM. We estimate that the NOAEL (No Observed Adverse Effect Level) for the atropine/scopolamine mixture lies between the lower two administered doses. Applying the uncertainty factor of 10, we propose a new provisional Acute Reference Doses (ARfDs) of the mixture, i.e. 0.01 µg kg(-1) BM for each alkaloid, and a further refinement using higher-tier approaches.

show abstract

Morphine, Scopolamine, and Atropine as Intravenous Surgical Premedicants

Cited by 9 publications

References 0 publications

Comparison of Rectal Diazepam and Subcutaneous Morphine‐Scopolamine Administration for Outpatient Sedation in Minor Oral Surgery

Comparison of Rectal Diazepam and Subcutaneous Morphine‐Scopolamine Administration for Outpatient Sedation in Minor Oral Surgery

Droperidol, Fentanyl and Morphine for I.V. Surgical Premedication

Acute effects of a low‐dose atropine/scopolamine mixture as a food contaminant in human volunteers

Contact Info

Product

Resources

About