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[Chlorprothixene for premedication in children: oral versus intramuscular route (author's transl)]
Insights
This study compared intramuscular versus oral chlorprothixene in children undergoing anesthesia. Both methods were equally effective, though oral administration may reduce side effects like hypotension.
Area of Science:
- Anesthesiology
- Pediatric Pharmacology
- Neuroscience
Background:
- Chlorprothixene is a neuroleptic agent used for premedication.
- Evaluating different administration routes for pediatric anesthesia is crucial for optimizing patient care and minimizing adverse events.
Purpose of the Study:
- To compare the efficacy and safety of intramuscular versus oral chlorprothixene in pediatric patients undergoing anesthesia.
- To assess various parameters including antisalivary action, reflex irritability, post-anesthetic vomiting, sedation, and analgesic requirements.
Main Methods:
- A double-blind study involving 200 children aged 11 months to 10 years.
- Patients received either intramuscular or oral chlorprothixene, with all patients also receiving intramuscular 1-hyoscyamine before anesthesia induction.
- Data collected on antisalivary action, reflex irritability, post-anesthetic vomiting, sedation, and analgesic needs.
Main Results:
- No significant differences were found between intramuscular and oral chlorprothixene regarding antisalivary action, reflex irritability, post-anesthetic vomiting, or analgesic requirements.
- Preoperative sedation was slightly more pronounced with the intramuscular route.
- Hypotension, an undesirable side effect, occurred more frequently with intramuscular premedication.
Conclusions:
- Both intramuscular and oral chlorprothixene are effective for pediatric premedication.
- Oral administration may be preferred due to a lower incidence of hypotension.
- An interval of 2 hours between oral premedication and anesthesia induction is recommended for optimal effect.
Abstract:
The effect of chlorprothixene (Taractan), a neuroleptic agent, administered either intramuscularly (1 mg/kg) or orally as a 4% solution (1,5-2 mg/kg), was compared in a double-blind study in 200 children between 11 months and 10 years of age. In addition, intramuscular 1-hyoscyamine (Bellafolin) was given to all patients 30 minutes before the induction of anaesthesia (0.005-0.01 mg/kg). With regard to antisalivary action, suppression of reflex irritability, frequency of post-anaesthetic vomiting, postoperative sedation and requirement of postoperative analgesics, there was no significant difference between the two methods. Preoperative sedation was slightly more pronounced with the intramuscular technique. An undesirable side-effect, hypotension, was observed more often after intramuscular than oral premedication. To obtain optimum effect, an interval of 2 hours between the oral premedication and induction of anaesthesia is recommended.