The Evaluation of Premedication in Children

Doughty, Andrew

doi:10.1097/00132586-196012000-00029

Cited by 10 publications

(21 citation statements)

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“…Trimeprazine tartrate (Vallergan) was introduced into clinical practice as an oral premedicant for children by Cope and Glover (1959) to induce a state "between sedation and basal narcosis". Its use is associated with salivary suppression, antiemesis, marked postoperative pallor and amnesia (Doughty, 1962).…”

mentioning

confidence: 99%

“…Although trimeprazine has found general acceptance among those hitherto accustomed to using the oral barbiturates, some doubt has been cast on its efficacy and freedom from undesirable sideactions. Gunner and Fox (1960) reported a progressive improvement in behaviour of children in the anaesthetic room as the dose of trimeprazine premedication was reduced, while Doughty (1962) showed that children premedicated with trimeprazine were less co-operative and less satisfactorily sedated than those who had received a control solution.…”

mentioning

confidence: 99%

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

Davies¹,

Doughty²

1966

British Journal of Anaesthesia

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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.

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confidence: 99%

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confidence: 99%

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

Davies¹,

Doughty²

1966

British Journal of Anaesthesia

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“…injection is the worst thing that happens to them in hospital (Doughty, 1959). In the placebo group 52% were graded as calm; this contrasts with Beeby and Morgan Hughes (1980) who quoted 81% satisfactory demeanour in unpremedicated children.…”

Section: Amnesiamentioning

confidence: 85%

“…In children (Boyd and Manford, 1973;Richardson and Manford, 1979;Beeby and Morgan Hughes, 1980) it is now accepted that the administration of premedication by mouth is safe, effective and preferred by the patient (Doughty, 1959). Lorazepam has been studied in children (Mundeleer, 1980) and appeared satisfactory.…”

Section: Discussionmentioning

confidence: 99%

Lorazepam in Children

Burtles¹,

Astley

1983

British Journal of Anaesthesia

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SUMMARYOne hundred patients aged 5-13yr were randomly allocated to four groups in a double-blind study of premedication. Drugs studied were lorazepam, diazepam and trimeprazine. A placebo group was included. All the drugs appeared satisfactory as premedicants. Lorazepam induced the most sedation immediately after surgery, but by 4 h lorazepam and diazepam appeared similar. Lorazepam produced better amnesia than the other drugs. There were no untoward side-effects and no cardiorespiratory depression in any group. Lorazepam appears a suitable premedicant for children.Lorazepam has been used successfully as an oral premedicant in adult patients (Paymaster, 1976; Dundee et al., 1977). Its desirable properties include anxiolysis (Harry and Richards, 1972; Maleet al., 1980), anterograde amnesia (Wilson and Ellis, 1973;Pandit, Heisterkamp and Cohen, 1976), minimal effects on cardiovascular and respiratory systems (Cormack, Milledge and Harming, 1976;Dundee, Johnston and Gray, 1976) and the long duration of action makes the timing of premedication less crucial (Fragen and Caldwell, 1976).In children (Boyd and Manford, 1973;Richardson and Manford, 1979;Beeby and Morgan Hughes, 1980) it is now accepted that the administration of premedication by mouth is safe, effective and preferred by the patient (Doughty, 1959). Lorazepam has been studied in children (Mundeleer, 1980) and appeared satisfactory. However, no comparison was made with an established drug.In the present study we have compared, in children, lorazepam, diazepam, trimeprazine and placebo as oral premedicants. PATIENTS AND METHODSOne hundred patients aged 5-13 yr were studied. The operations performed were mainly plastic surgical procedures, ENT operations or minor general surgical procedures. Children were drawn from three wards. Day cases were not included, nor were

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“…It should be emphasized that this dosage schedule was not absolute, but rather served as a guide and was varied according to the procedure and the condition of the patient. Also, this combination of drugs is not to be considered the best or the only satisfactory sedative mixture, for there appears to be no universal agreement as to which drug or combination of drugs is best (7,14). Rather it may be said that this combination of drugs has been successful in our hands.…”

Section: Discussionmentioning

confidence: 99%