ORAL PREMEDICATION IN CHILDREN WITH TRIMEPRAZINE: The Effect of varying Dosage and Timing

Abstract

In the belief that both dosage and timing of premedication may be important, a double blind trial was carried out on 484 children undergoing adenotonsillectomy receiving trimeprazine with hyoscine according to four differing methods within the limits suggested by the manufacturers' instructions. Thus trimeprazine was given in doses of 1 or 2 mg/lb. (2.2 or 4.4 mg/kg), 1 or 2 hours pre-operatively. The most intense action of the drug was evident when the stronger dose was given 2 hours before operation. However, this was associated with a comparative deterioration in behaviour of the children in the anaesthetic room and a higher frequency of undue postoperative pallor. Possible advantages of the more intense action of trimeprazine are salivary suppression and amnesia. Postoperative vomiting was infrequent with all four methods of premedication. A plea is made for the more critical evaluation of premedicant drugs.

Comparative Study of Lorazepam and Trimeprazine for Oral Premedication in Paediatric Anaesthesia

“…Lacking these facilities we felt unjustified in including a control group within our trial. Trimeprazine produced the only comatose children in this series, confirming previous reports (Davies and Doughty, 1966).…”

“…Our results for satisfactory verbal response, lack of hand withdrawal on venepuncture and overall satisfactory behaviour in the anaesthetic room are similar to those for trimeprazine reported by Davies and Doughty (1966) and lorazepam has demonstrated no significant advantage. We simplified the classification of verbal response by omitting the category "whimpered", which other authors have considered satisfactory.…”

ORAL PAEDIATRIC PREMEDICATION: A comparative trail of either phenobarbitone, trimeprazine or diazepam with hyoscine, prior to guillotine tonsillectomy

“…and a dose which is least likely to produce postoperative pallor (1 mg/lb.) (Davies and Doughty, 1966).…”

“…A review of the recent literature on the use of trimeprazine for oral premedication in children (Cope and Glover, 1959;Doughty, 1962;Davies and Doughty, 1966) and the practice of most of our colleagues had led to the conclusion that trimeprazine was the best choice for oral premedication of children for most surgical procedures. It was, therefore, a little disheartening to find that trimeprazine had fallen into disrepute in this hospital because of two of its side effects, namely, postoperative pallor (said to disguise the presence of postoperative haemorrhage) and the occasional occurrence of marked depression of the central nervous system even before operation.…”

Premedication of Children With Papaveretum-Hyoscine

“…After intubation, anaesthesia was maintained with nitrous oxide, oxygen and 0.5 per cent halothane by spontaneous respiration. The conditions under which the children were anaesthetized and the methods of evaluation were essentially similar to those used in previous trials (Doughty, 1959(Doughty, , 1962Davies and Doughty, 1966).…”