Premedication in children undergoing day-care surgery

Area of Science:

• Anesthesiology
• Pediatric Surgery
• Pharmacology

Background:

• Premedication is crucial for managing pediatric anxiety and pain during surgery.
• Traditional premedication often involves intramuscular (i.m.) morphine and atropine, which can have significant side effects.
• Day-care surgery requires effective and safe premedication strategies with rapid recovery.

Purpose of the Study:

• To evaluate an oral preparation of dichloralphenazone and paracetamol as an alternative premedication in pediatric day-care surgery.
• To compare the efficacy and safety of this oral mixture against i.m. morphine and atropine.
• To identify the advantages and disadvantages of each premedication method.

Main Methods:

• A study involving 562 children undergoing day-care surgery.
• Comparison of an oral preparation (Paedosed) containing dichloralphenazone and paracetamol with i.m. morphine and atropine.
• Observations recorded both in hospital and at home.

Main Results:

• The oral dichloralphenazone and paracetamol mixture was found to be a viable alternative to i.m. morphine and atropine.
• Morphine was associated with several disadvantages when compared to the oral preparation.
• Intravenous (i.v.) analgesia supplementation was necessary for more painful procedures when using the oral mixture.

Conclusions:

• The oral preparation of dichloralphenazone and paracetamol is a suitable alternative premedication for pediatric day-care surgery.
• This oral mixture offers advantages over i.m. morphine and atropine, particularly regarding side effects.
• Careful consideration of supplemental i.v. analgesia is important for managing pain in more demanding surgical cases.