8. Premedication

Question 1

Indications for

Answer 1

1. Anxiolysis
2. Analgesia pre empttive
3. Reduction of secretions
4. Reduction of volume and pH gastric contents
5. Reduction of PONV
6. Reduction of vagal reflexes to ETT
7. Specific indications ABX / ACOAG

Question 2

Advantages and disadvantages commonly used sedatives and analgesics
Include dose where possible

Answer 2

1. Benzo
2. Ketamine
3. Fentanyl
4. Clonidine

Question 3

1. Benzos

Answer 3

Midazolam still main agest in use

Anxiolytic & Amnesic

Reduces postop behaviural distubaal

Min affect recovery and d/c times
-when dosed at 0.5mg/kg
onset 15-20 m

Antiemetic effect a/w

Can have opposite effect and cause hyperactivity

Question 4

1. Benzo

admin routes / doses

Answer 4

Admin man routes

PO 0.5mg kg - dilute w/ juice

Nasal 0.2mg/kg faster onset
less co op required
a/w uring sensatio

Sublingual 0.2 mg/kg rapid onset / requires compliance

IV 0.1-0.2mg/kg
requires canulla but fast

Question 5

2. Ketamine

Answer 5

Variety routes avail
IV IM PO NASAL / SL

Dose 5-8mg/kg

Analgesic / anxioltyic / sedative / bdilator

sympathetic stimualtion
-secretions

Use idaz ineffective

Halluncations and emergence reactions common
countracted benzo adjunct

Dystonic movement

?delay discharge - less suitable day surgery

Question 6

3. Fentanyl

Answer 6

Stong Op3 agonist
Comes in lollipop

15-20 mcg - a/w analgesia anxiolysis

Anaglesic affect 15-20 min

A/W
Nause vomiting itch resp depression

Question 7

4. Other Options

Answer 7

Paracetamol 20mg /kg

Brufen 10mg/kg

Clonidine 1-4mcg / kg