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Oral premedication in children
Insights
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.
- 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.
Abstract:
Preoperative and postoperative sedation, postoperative analgesia and vomiting were assessed following four different oral premedications in 143 children aged 1-10 years, weighing 10-30 kg, and undergoing elective adenotonsillectomy or inguinal surgery. Diazepam, diazepam combined with droperidol, trimeprazine and trimeprazine combined with droperidol were compared in a double-blind trial in conjunction with a standardised inhalational anaesthetic technique employing an intraoperative narcotic. Trimeprazine produced significantly more preoperative sedation (P less than 0.001) and was associated with enhanced postoperative analgesia (P less than 0.01). The incidence of postoperative vomiting was significantly less in the group receiving trimeprazine (P less than 0.001). The addition of droperidol to diazepam and trimeprazine only marginally improved the performance of those drugs but significantly prolonged postoperative recovery times. This was more marked when droperidol was combined with trimeprazine.