6 A's of Premedication


Anxiolysis:

  1. Temazepam 20-30 mg
  2. Diazepam 10-20 mg
  3. Lorazepam 2-4 mg

Amnesia:

  1. Lorazepam 2-4 mg

Antiemetic:

  1. Metoclopramide 10 mg oral or iv
  2. Ondanetron 4-8 mg oral or iv
  3. Cyclizine 50 mg im or iv
  4. Hysocine 1mg transdermal patch

Antacid:

  • Oral sodium citrate 30 ml immediately preinduction
  • Ranitidine 150 mg orally 12 hourly and 2 hour preoperatively
  • Metoclopramide 10 mg orally preoperatively
  • Omeprazole 30-40 mg 3-4 hour preoperatively

Anti-autonomic:

  • Anticholinergic: Glycopyrollate 0.2-0.4 mg im
  • Antisympathomimetic: Atenolol 25-50 mg orally or esmolol iv

Analgesia:

  1. Morphine
  2. Pethidine
  3. Fentanyl

Miscellaneous:

  1. Steroids: To patients on long-term treatment or who have received them within the past 3 months
  2. Antibiotics: To patients with prosthetic or diseased heart valves, or undergoing joint replacement
  3. Anticoagulants: As DVT prophylaxis
  4. Transdermal Glyceryl Trinitrate (GTN): To patients with IHD
  5. Eutectic mixture of local anesthetics (EMLA): a topically applied local anesthetic cream to reduce the pain of inserting an IV cannula.



What do you see? What do you feel?
Creative Commons License