No abstract available.
Bronchoscopy* ; Humans ; Outpatients* ; Premedication*

No abstract available.
Child* ; Humans ; Premedication*

Objective: To compare the efficacy and safety of the combination of Dexmedetomidine (Dex) and Ketamine (Ket) administered via the intranasal (IN) route on sedation of children aged 0 to 12 years old prior to elective surgery or procedural sedation as compared to Intranasal Dexmedetomidine. Methods: Relevant studies were identified after a literature search on electronic databases as PubMed, Cochrane Library, Google Scholar and Science Direct. Meta-analyses of mean differences were performed to examine differences in sedation onset and recovery times between IN Dex-Ket and IN Dex. Meta-analyses of proportions were performed to estimate the incidence of sedation success, satisfactory sedation at parental separation and mask induction, and incidence of adverse events. Review Manager 5.4.1 was used for statistical analysis. Results: Six articles (388 patients) were included. The overall incidence of sedation success was higher among children premedicated with IN Dex-Ket (RR = 1.05; 95%CI = 0.97,1.13; P = 0.27, I2 = 20%) however was not statistically significant. Children given IN Dex-Ket had faster sedation onset time (WMD = -7.17; 95%CI = -12.44, -1.89; P=0.008) with greater incidence of satisfactory sedation at mask induction (RR = 0.71; 95%CI = 0.53, 0.94; P = 0.02). There was no significant difference as to recovery time and incidence of adverse events among the groups. Conclusion Premedication with IN Dex-Ket is as safe as IN Dex but of better efficacy as evidenced by faster sedation onset time and smoother inhalational induction without increasing clinically relevant adverse events.
Dexmedetomidine ; Ketamine ; Premedication

To identify the changes in professional services pattern after introducing the deligated system of claims review started in 1982, a university hospital under this system was examined. For comparison, claims of the hospital to Federation of Korean Medical Insurance Societies, where this system is not accepted, were reviewed. A total of 600 cases each were studied operated at the Departments of General Surgery & Orthopedic Surgery in 1981 and 1983. The results are summarized as follow: 1. Percentages of hospital changes for basic care was decreased by 10.2% and that for medical service increased by 8.4% in 1983. 2. After the introduction of the deligated review system, percentages of cutting off the claims was decreased by 12.4% for basic care and increased by 3.8% for medical services. 3. Percentage of testing liver function, and the frequency of administering high cost intravenous fluid injection, applicating Robinul as anesthetic premedication were decreased respectively after introducting the deligated services system.
Insurance ; Insurance Claim Review ; Liver ; Orthopedics ; Premedication

There have been many reports stating that halperidol premedication has been used for sefative and antiemetic effects. Therefore we utilized haloperidol as a premedicant for the purpose of obtaining the above effects. Over a period of one year from march 1978 to February 1979, 0.1mg haloperidol per kilogram of body weight was given to 747 patients. The results were as follows. 1)The extrapyramidal symptioms appeared in children, especially in the 10-year old group. 2) Large doses of haloperidol were more likely to cause to extrapyramidal symptoms than smaller doses(over 0.1mg/kg) 3)The effects of haloperidol lasted for a considerable duration of time after administration, (about 24-48 hous).
Antiemetics ; Body Weight ; Child ; Haloperidol* ; Humans ; Premedication*

With with use of Tono-pen, we investigated the degree of reduction in intraocular pressure of the Honan intraocular pressure reducer(HIPR) with preoperative use of dichlorphenamide and mannitol or without. Seventy five patients scheduled for cataract surgery were divided into 4 groups by preoperative medication. Intraocular pressure was measured before preoperative medication and in process of time after external compression with the Honan intraocular pressure reducer(HIPR) following retrobulbar injection. There was no additive effect on the reduction of intraocular pressure with the preoperative use of dichlorphenamide and mannitol. A rapid initial reduction in intraocular presure over the first 5 minutes of compression was followed by a more gradual reduction from 5 to 20 minutes. We concluded that the compression of up to 20 minutes duration without the preoperative use of dichlorphenamide and mannitol is adequate.
Cataract* ; Dichlorphenamide ; Humans ; Intraocular Pressure* ; Mannitol ; Premedication*

BACKGROUND: A majority of patients undergoing chemical peeling complain of pain severe enough to disturb the process of the peeling. However, there has been few controlled studies on pain control during chemical peeling. OBJECTIVES: We evaluated the efficacy and safety of pretreatment with intramuscular ketorolac (Tarasyn, 30 mg) and oral diazepam(Valium, 5 mg) in comparison with control and diazepam groups, and compared the sensitivity of pain between two sexes. METHODS: The patients were randomly assigned to one of three groups; control, diazepam, and ketorolac plus diazepam groups. Pain intensity was assessed 5 times at every ten minutes from the beginning of the peeling using visual analog scale(VAS). RESULTS: At every 10 minutes of pain assessment, ketorolac plus diazepam group recorded the lowest VAS among the three groups. Except at the first 10 minutes, nificant. There was no significant difference in the pain intensity between the sexes at all five times. After application of Jessner`s solution, there was significant increase of VAS in all groups. CONCLUSION: The ketorolac pretreatment is a safe and effective modality of pain relief prior to chemical peeling without the adverse reactions.
Diazepam ; Humans ; Ketorolac* ; Pain Measurement ; Premedication*

An imaginative innovation to shorten hospital stays as a means to reduce patient charges, is out-patient surgery. This procedure also minimized the inconvenience and disruption of the family unit, reduced the opportunities for cross-infection, and freed hospital beds for the more seriously ill patients Since the concept of out-patient surgical service was organized, managed, and performed in the Hanyang Medical Center, we had experience of 132 ambulatory anesthetics during the last two years (from Jan. 1974. to Dec. 1975 ). The results are summarized as follower 1. Preanesthetic examination should be routinely checked with Hb., Hct., urinalysis and chest x-ray. 2. Premedication should be administered preanesthetically, atropine sulfate intravenously. 3. ASA class 1 patients should be chosen for short (less than 1 hour) procedures. 4. Anesthesia is induced with Epontol+S.C.C. and maintained with Halothane+N2O+O2. 5. We suggest that ambulatory anesthesia should be more carefully planned, organized, and managed.
Anesthesia* ; Anesthetics ; Atropine ; Humans ; Length of Stay ; Outpatients ; Premedication ; Thorax ; Urinalysis

Although anaphylactic shock during the perioperative period is rare, it can be lethal due to severe cardiovascular and respiratory collapse. Midazolam is generally used as premedication for relieving anxiety about the operation, and the danger of anaphylactic shock after intramuscular injection is not widely recognized. We report the first case of anaphylactic shock occurring during the perioperative period after intramuscular injection of midazolam. Since anaphylactic shock after intramuscular injection can be of slow onset, the operation should be delayed if an anaphylactic reaction is suspected, even if the symptoms are limited. In addition, anesthesiologists should be prepared for the occurrence of anaphylaxis at any time in the perioperative period.
Anaphylaxis* ; Anxiety ; Injections, Intramuscular* ; Midazolam* ; Perioperative Period* ; Premedication

BACKGROUND: When appropriate premedication is required for pediatric patients, the route of drug administration and the patient's age may affect the drug response. This study was designed to evaluate the premedicative effects of intranasal, oral, and rectal midazolam in preschool (1~6 year) and school (6.1~10 year) ages. METHODS: One hundred fourteen children aged 1~10 years were randomly allocated into three groups to receive midazolam via intranasal (0.3 mg/kg), oral (1.0 mg/kg), or rectal (1.0 mg/kg) route. Sedation scores were evaluated at the arrival in preanesthetic room, drug administration, 5, 10, 20 and 30 min after drug administration, separation from parent, mask application, and induction with inhalational agent. Time to sedation scores of 3 and 4 and time to complete recovery from general anesthesia were recorded. RESULTS: At the drug administration, the incidence of crying was significantly higher in nasal group than in oral and rectal groups, especially in pre-school age group (87.5, 23.5. 40.9% for nasal, oral and rectal groups, respectively). At 5, 10 and 20 min after drug administration, sedation scores were significantly higher in nasal and rectal groups than in oral group. At separation, mask application and inhalational induction, sedation scores were significantly higher in oral and rectal groups than in nasal group. Time to sedation score of 3 and time to complete recovery were significantly longer in oral group than in nasal and rectal groups. CONCLUSIONS: In pre-school age, almost all the children cried at drug administration in nasal group, and onset and recovery were prolonged in oral group, so rectal route was suitable. In school age, nasal route was appropriate because of the lower frequency of crying at the drug administration and rapid onset and recovery. In overall age, rectal route was better because of the lower frequency of crying and rapid onset and recovery. This study suggests that administration route should be considered according to the age of pediatric patient to obtain appropriate premedication for pediatric patients.
Anesthesia, General ; Child* ; Crying ; Humans ; Incidence ; Masks ; Midazolam* ; Parents ; Premedication*