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Oral premedication in children.

J H Van der Walt, B Nicholls, M Bentley

    Anaesthesia and Intensive Care
    |May 1, 1987
    PubMed
    Summary
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    Trimeprazine provided superior preoperative sedation, postoperative pain relief, and reduced vomiting in children undergoing surgery. Adding droperidol offered minimal benefits but significantly delayed recovery.

    Area of Science:

    • Pediatric Anesthesiology
    • Pharmacology
    • Surgical Care

    Background:

    • Optimizing pediatric premedication is crucial for managing sedation, analgesia, and postoperative nausea and vomiting (PONV).
    • Evaluating different oral premedication options helps tailor anesthetic management for pediatric surgical patients.

    Purpose of the Study:

    • To compare the efficacy of four oral premedications in pediatric patients undergoing elective surgery.
    • To assess preoperative sedation, postoperative analgesia, and incidence of postoperative vomiting.

    Main Methods:

    • A double-blind trial involving 143 children (aged 1-10 years) undergoing elective adenotonsillectomy or inguinal surgery.
    • Comparison of diazepam, diazepam with droperidol, trimeprazine, and trimeprazine with droperidol.

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  • Standardized inhalational anesthesia with intraoperative narcotic was used.

    • Main Results:

    • Trimeprazine significantly improved preoperative sedation (P < 0.001) and postoperative analgesia (P < 0.01).
    • Trimeprazine significantly reduced the incidence of postoperative vomiting (P < 0.001).
    • Droperidol addition provided marginal benefits but significantly prolonged recovery, especially when combined with trimeprazine.

    Conclusions:

    • Trimeprazine is an effective oral premedication for pediatric surgery, offering better sedation, analgesia, and antiemetic effects.
    • The addition of droperidol to premedication regimens should be used cautiously due to prolonged recovery times.