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Premedication in the United States: a status report
1Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06510, USA.
Anesthesia and Analgesia
|February 1, 1997
Summary
Sedative premedication practices in anesthesia vary significantly by patient age and U.S. region. Health Maintenance Organization (HMO) penetration independently predicts premedication use in adults and children.
Area of Science:
- Anesthesiology
- Medical Practice Patterns
Background:
- Sedative premedication is a common practice before anesthesia.
- Variations in its use suggest a lack of standardized protocols.
Purpose of the Study:
- To assess current sedative premedication practices in the United States.
- To identify factors influencing the use of sedative premedication.
Main Methods:
- A mailing survey was sent to 5396 randomly selected American Society of Anesthesiologists members.
- Response rate was 46% (n=2421).
- Data analyzed for variations by age, geography, and Health Maintenance Organization (HMO) penetration.
Main Results:
- Premedication use varied by age (least in <3 years, most in <65 years) and region (least in Northeast, most in Southeast).
- Midazolam was the most frequent premedicant (>75% in adults and children).
- HMO penetration was negatively correlated with premedication use and an independent predictor.
Conclusions:
- Significant geographical and age-related variations in sedative premedication exist.
- Lack of consensus among anesthesiologists regarding premedication necessity.
- HMO penetration appears to influence the delivery of anesthetic care components.