OBJECTIVETo compare the effects of penehyclidine hydrochloride, atropine and scopolamine as the preanesthetic medication before operation for patient with cleft lip/palate (CL/P) who would undergo general anesthesia.

METHODS120 CL/P patients who would undergo general anesthesia with tracheal intubation as research objects were chosen. The patients were divided into three groups randomly, group of penehyclidine hydrochloride (group PH), group of atropine (group ATR) and group of scopolamine (group SCO), 40 patients in each group. Penehyclidine hydrochloride (0.01 mg/kg), atropine (0.01 mg/kg) or scopolamine (0.006 mg/kg) was given respectively to the patients. The changes of heart rate, temperature, blood pressure and the secretion of respiratory tract were observed before medication, 15 minutes and 30 minutes after medication, after trachea cannula and after operation.

RESULTSThere were no significant changes in heart rate, temperature and blood pressure in group PH after medication (P > 0.05). The heart rate and temperature in group ATR and group SCO increased significantly after medication (P < 0.05), however, the blood pressure had no obvious change (P > 0.05). The secretion of respiratory tract was decreased significantly in group PH comparing to group ATR and group SCO when the operation was over (P < 0.05).

CONCLUSIONPenehyclidine hydrochloride has no significant effect on heart rate, temperature and blood pressure to the patients, and it's effect of secretion inhibition is longer and it is better than atropine and scopolamine.

Decisions about stopping or continuing medications perioperatively should be based on withdrawal potential, the potential for disease progression if therapy is interrupted, and the potential for drug interactions with anesthesia. In general, most medications are tolerated well through surgery and do not interfere with anesthetic administration. Therefore, most drugs should be continued through the morning of surgery. However, some medications are known to influence surgical risk or surgical decisions (e.g., antiplatelet agents, anticoagulants, some hormonal therapies, and herbal remedies), so it is important to obtain a complete medication list from the patient and to advise adjusting doses or discontinuing certain potentially complicating medications in advance of surgery. This article reviews general recommendations for perioperative management of a number of common medication classes.
Anesthesia* ; Anticoagulants ; Disease Progression ; Drug Interactions ; Humans ; Medication Therapy Management ; Perioperative Care ; Platelet Aggregation Inhibitors ; Preanesthetic Medication

It has been well known that successful anesthesia is provided by rendering patients free from apprehension and fear prior to operation. This report is concerned with a new sedative compound which appears to reduce anxiety-tension and relax skeletal muscles. Preanesthetic usefulness of diazepam, which is a derivative of benzodia-zepine and has a high safety index as a preanesthetic medication agent, has been clinically assessed by a standard double blind study on 288 patients in this hospital. They received diazepam(0.3mg/ kg), meperidine hydrochloride (1.0~1.5mg/kg) or saline (1.0ml) via intramuscular route. The following are the results: 1) Diazepam was effective in producing a sound sleep during the preoperative night. 2) Diazepam was effective in reducing apprehension and fear immediately prior to induction of anesthesia. 3) Less nausea and vomiting as well as better sedation were produced by diazepam than by meperidine hydrochloride.
Anesthesia ; Diazepam* ; Double-Blind Method ; Humans ; Meperidine ; Muscle, Skeletal ; Nausea ; Preanesthetic Medication* ; Vomiting

Oxyen consumption of surgical patients was measured by McKesson Metabolar (Model 185) on the Recording Metabolar Chart (M-147) in four groups: group A, at resting state immediately before preanesthetic medication; group B, immediately following induction of anesthesia with thiopental (10 mg./kg.); group C. 30 minutes after surgical ether anesthesia; and group D, when conciousness returned during the stay in the recovery room. The results are as follows: (1) Thiopental reduced oxygen consumtion by 25 per cent. (2) Ether anesthesia reduced, oxygen consumption by 59 per cent. (3) During recovery from anesthesia, oxygen consumption was 28 per cent below the control. (4) Comparing with other data, ether anesthesia reduced oxygen consumption significantly more than fluothane or nitrous oxide did.
Anesthesia ; Anesthesia, General* ; Ether ; Halothane ; Humans ; Nitrous Oxide ; Oxygen Consumption* ; Oxygen* ; Preanesthetic Medication ; Recovery Room ; Thiopental

Clonidine, an 2 agonist, has been shown to be effective as preanesthetic medication in adults. To evaluate the effects of clonidine on the sedation and cardiovascular changes induced by intubation, we administered clonidine (2.0-2.5g/kg, 4.5-5.0g/kg, peros) 90-120min before induction of anesthesia. We measured heart rate, systolic pressure and diastolic pressure before premedication, before induction, after intubation and 5, 10, 15, 20 and 30 min after intubation and evaiuated sedative sction before induction. The results are as follows: 1) Before intubation heart rate decreased significantly in both clonidine groups compared with diazepam group (P<0.05). 2) Before intubation clonidine 4.5-5.0g/kg group produced a significant reduction in systolic pressure compared with diazepam group (P<0.05). 3) After intubation systolic and diastolic blood pressure increased in all group but the increasing rate was significently less then in clonidine 4.5-5.0g/kg group (P<0.05). 4) After intubstion the increase in heart rate in both clonidine groups were significsntly less than in diazepam group (P<0.005). 5) Sedative actions were not significantly different in all groups.
Adult ; Anesthesia ; Blood Pressure ; Cardiovascular System* ; Clonidine* ; Diazepam ; Heart Rate ; Humans ; Intubation ; Preanesthetic Medication ; Premedication

Myasthenia gravis is usually defined as a state of abnormal fatigability. The cause of myasthenia gravis is not known. Several disorders tend to occur more frequently in patients with myasthenia gravis, such as hyperthyroidism or other thyroidal disorder. Anesthetic experiences with thymectomies for two patients with myasthenia gravis has been reported. Both of them tolerated the surgical procedures under endoteracheal Nitrous oxide-Oxygen-Halothane anesthesia well. Diagnosis and clinical features including choice of preanesthetic medication, anesthetic agents, techniques and of neuromuscular blocking agents for myasthenic patients have been discussed. Paramount importance of rigid attention to ventilation, the maintenance of a patent airway and the removal of secretions whenever necessary for the patient safety throughout operative and postoperative period has been stressed.
Anesthesia ; Anesthetics ; Diagnosis ; Humans ; Hyperthyroidism ; Myasthenia Gravis* ; Neuromuscular Blocking Agents ; Patient Safety ; Postoperative Period ; Preanesthetic Medication ; Thymectomy ; Thyroid Gland ; Ventilation

BACKGROUND: Most surgical patients experience perioperative anxiety. This anxiety can effect the amount of preanesthetic medication and anesthetic agents needed, and contributes to postoperative pain. The effect of music on perioperative patient anxiety was studied. METHODS: Forty patients undergoing surgery with spinal anesthesia, were divided into two groups. Group I (n = 20) did not listen to music, and Group II (n = 20) listened to music selected by the patient. At ward, hemodynamic variables including systolic and diastolic blood pressures and pulse rates were measured as control values. Hemodynamic variables and the anxiety scores by the Hamilton anxiety rating scale and the Visual Analogue Scale (VAS) were prepared for Group I and Group II in the operating room. RESULTS: No difference was observed between the groups with regard to systolic blood pressure, diastolic blood pressure, mean arterial pressure, or pulse rate when patients arrived at the operating room. In Group II, 30 minutes after listening to music, anxiety scores, VAS, systolic blood pressures, and mean arterial pressures were significantly lower than in Group I. CONCLUSIONS: Music was found to effectively reduce intraoperative anxiety.
Anesthesia, Spinal* ; Anesthetics ; Anxiety* ; Arterial Pressure ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Music* ; Operating Rooms ; Pain, Postoperative ; Preanesthetic Medication

Anesthetic experience with thymectomies for two patients with myasthenia gravis has been reported. Both of them talerated the surgical procedures under endotracheal nitrous oxide-oxygen-halothane anesthesia well, but one of tbem expired from cholinergic crisis on the 3rd postoperative day. Chemical diagnosis of myasthenia gravis and the salient clinical features including choice of preanesthetic medication, anesthetic agents, techniques and of neuromuscular blocking agents for myasthenic patients have been discussed. Paramount importance of rigid attention to ventilation, the maintenance of a patent airway and the removal of secretions by bronchoscopy or tracheostomy whenever necessary for the patient safety throughout operative and postoperative period has been stressed. Frequent determinations of pulmonary function and the use of edrophonium test in avoiding cholinergic crisis are advocated.
Anesthesia ; Anesthetics ; Bronchoscopy ; Diagnosis ; Edrophonium ; Humans ; Myasthenia Gravis ; Neuromuscular Blocking Agents ; Patient Safety ; Postoperative Period ; Preanesthetic Medication ; Thymectomy ; Tracheostomy ; Ventilation

BACKGROUND: Most surgical patients experience preoperative anxiety. This anxiety can effect the amount of preanesthetic medication and anesthetic agents needed, and contribute to postoperative pain. Music has been recognized as a way to reduce anxiety and fear. The effect of hymn and sutra-chanting on the preanesthetic patient's anxiety in the operating room were studied. METHODS: 98 patients were divided into two groups according to the religionist or atheism. Group I(n=50, religionist) and Group II(n=48, atheism) listened to hymn or sutra-chanting according to the patient's religion and choice. At ward, hemodynamic variables including systolic and diastolic blood pressure and pulse rate were measured as control values. Hemodynamic variables and measurements of anxiety score with Hamilton anxiety rating scale were made at pre-music and post-music in the operating room. Also, patient's response to the music was measured on the postoperative 5-6th day. RESULTS: There were no difference between ward, pre-music, and post-music in terms of systolic pressure, diastolic pressure and pulse rate except the systolic pressure at pre-music that is grater than that of controls in both groups. Both group, anxiety score at post-music was significantly lower than that of pre-music (10.2+/-3.4 vs 4.4+/-2.9, 11.0+/-3.2 vs 5.7+/-3.1). At post-music, anxiety score in Group I showed significant reduced compaired with Group II (p<0.05). Patients showed relatively good satisfaction with music in both groups. CONCLUSION: The results suggest that music with hymn and Sutra-chanting were effective to reduce preanesthetic anxiety in both religionist group and atheism group.
Anesthesia ; Anesthetics ; Anxiety* ; Blood Pressure ; Heart Rate ; Hemodynamics ; Humans ; Music ; Operating Rooms* ; Pain, Postoperative ; Preanesthetic Medication ; Premedication

BACKGROUND: This study was designed to evaluate the efficacy and safety of midazolam premedication administered by a jet-injector in pediatric patients. METHODS: Children undergoing outpatient surgery were randomized into three groups: intravenous induction with thiopental sodium (control group, n = 20), oral midazolam premedication (PO-med group, n = 20) or midazolam premedication using a jet-injector (Jet-med group, n = 20). In the PO-med and Jet-med group patients, anesthetic induction was performed by sevoflurane inhalation and an intravenous catheter (IVC) was inserted after the children had been anesthetized by sevoflurane inhalation. For the control group patients, an IVC was placed in the preoperative holding area. Agitation scores were recorded in the preoperative holding area and recovery room. Anesthesia times and the views of the medical staff concerning the technique benefits were also noted. Patients and parents were interviewed on the following day. RESULTS: Maximum agitation scores in the preoperative holding area and during separation with parents were significantly lower in the PO-med and Jet-med groups. The induction time was significantly longer in the PO-med and Jet-med groups. No statistically significant differences were found for the recovery characteristics. Though interviews with patients and parents produced similar results for patients in each group, the medical staff satisfaction levels were significantly higher for patients in the PO-med and Jet-med groups. CONCLUSIONS: The findings of this study suggest that the application of the jet-injector for midazolam premedication may be clinically useful in children who do not have an IVC. The use of the jet-injector could be a substitute for the oral route for midazolam administration.
Ambulatory Surgical Procedures ; Anesthesia ; Catheters ; Child ; Dihydroergotamine ; Humans ; Inhalation ; Medical Staff ; Midazolam ; Parents ; Preanesthetic Medication ; Premedication* ; Recovery Room ; Thiopental