Download - Preanaesthetic medication himani m malhotra
![Page 1: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/1.jpg)
PREANAESTHETIC MEDICATION
By:Himani Manju Malhotra
2nd MBBSRoll no: 52
![Page 2: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/2.jpg)
• What are pre-anaesthetic drugs?
• Why are pre-anaesthetic drugs given?
• What are the drugs whichare included in pre-anaesthetic
medication?
• When are these drugs given?
![Page 3: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/3.jpg)
WHAT & WHYPreanaesthetic medication refers to the use of drug before
anaesthesia to make it more pleasant & safe.The aims are:1) To relieve anxiety.2) To provide haemodynamic stability.3) To induce sedation & reduce metabolic rate.4) To provide analgesia and amnesia.5) To decrease the chances of aspiration.6) To control oral &respiratory secretions.7) To prevent postoperative nausea and vomiting.8) To control infection.
![Page 4: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/4.jpg)
PREANAESTHETIC MEDICATION
• Benzodiaze-pines like diazepam(5-10mg) & lorazepam(2mg oral or 0.05 mg/kg i.m. 1hour before), produce tranquility & smoothen induction. Diazepam is also centrally acting skeletal muscle relaxant.
• There is loss of recall of perioperative events with little respiratory depression or post operative vomiting. They counteract CNS toxicity of local anaesthetics & are being used along with pethidine/fentanyl for minor surgical and endoscopical procedures.
1-SEDATIVE-ANTIANXIETY DRUGS
![Page 5: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/5.jpg)
2-OPIOIDS-TO PROVIDE ANALGESIA
• Earlier morphine was given, it showed disadvantage of-i. Respiratory depressantii. Causes peripheral vasodilatation responsible for
hypertension.iii. Shows anti-diuretic action.iv. Causes meiosis.• Use of opioids is now mostly restricted to those having
preoperative pain. When indicated, fentanyl is mostly injected i.v. just before induction.
• Given i.v. just before induction or i.m. 1 hour before surgery.
![Page 6: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/6.jpg)
3-ANTICHOLINERGICS• Earlier Atropine was used, which is now replaced
by Glycopyrolate.Atropine showed the following advantages-i. Atropine prevents vasovagal shock.ii. It causes drying up of secretions making
intubation easy.iii. It increases heart rate.However, it showed CNS effects due to which it was
replaced by Glycopyrolate.
![Page 7: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/7.jpg)
ACTION ATROPINE GLYCOPY-ROLATE
1-Antisecetory ++ +++
2-Tachcardia +++ ++
3-CNS effects + -
4-Bronchodilatation ++ ++
![Page 8: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/8.jpg)
4-H2 BLOCKERS/PROTON PUMP INHIBITORS
• Rantidine(150mg) or omeprazole(20mg) or famotidine(20mg) are given night before and in the morning. They benefit by raising the pH of gastric juice & may also reduce its volume & thus chances of regurgitation. The chances of reflux & damage to lungs on aspiration (Mendelson’s syndrome) is minimal if volume of gastric juice is <25ml & pH is >3.5. prevention of stress ulcers is another advantage.
![Page 9: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/9.jpg)
5-ANTIEMETICS
• Ondensetron (4-8mg) i.v. is selective 5-HT3 blocker has been found highly effective in reducing the incidence of post-anaesthetic nausea & vomiting. It is practically devoid of side-effects & has become antiemetic of choice in anaesthetic practice.
![Page 10: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/10.jpg)
6-TO CONTROL INFECTIONS
• The timing of antibiotic should be adjusted so that peak blood kevels are achieved at the time of skin incision. Mostly, antibiotic is given i.v. 5-10 minutes before incision. If given orally, should be given 1-2 hours before the surgery.
![Page 11: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/11.jpg)
7-TO DECREASE CHANCES OF ASPIRATION
Patient should be fasting for 8 hours for solid food & 3-4hours for clear fluids. Clear juices only inc water and juice without pulp, tea coffee are considered as unclear fluids so full fasting of 8 hours is needed.
FOR CHILDREN- 6-8 hours for solid food & 2-3 hours for clear fluids is sufficient.
FOR INFANTS(on milk)-fasting for 4 hours for milk & 2hours for water is sufficient.
![Page 12: Preanaesthetic medication himani m malhotra](https://reader036.vdocuments.us/reader036/viewer/2022082510/58f9b155760da3da068bbfbe/html5/thumbnails/12.jpg)
THANKYOU!