Rectal versus intramuscular morphine-scopolamine as premedication in children

Intramuscular morphine-scopolamine for premedication was compared with a hydrogel of the same drugs for rectal administration in 205 healthy children scheduled for minor ENT surgery. The intramuscular dose was 0.15 +/- 0.006 mg x kg-1 compared to 0.25 +/- 0.015 mg x kg-1 rectally. Reaction at administration and anaesthetic induction, incidence of intraoperative airway difficulties, Spo2, ECG changes, postoperative pain and incidence of nausea were recorded. The administration for the rectal hydrogel group worked better and resulted in less postoperative nausea and slightly more postoperative pain. The children's behaviour at anaesthesia induction and the frequency of perioperative complications were similar in both groups. We conclude that for minor ENT surgery on children, premedication with rectal hydrogel of morphine-scopolamine is a good alternative to intramuscular morphine-scopolamine.