Preanesthetic medicaments are administered for one or more of several reasons: (1) to relieve apprehension, (2) to supplement the anesthetic, (3) to relieve pain, and (4) to control vomiting. Many modifications of standard techniques have been studied in an effort to provide more adequate relaxation with greater safety. The classic preoperative combination included morphine and scopolamine hydrobromide or atropine, usually in a ratio of 25:1.1 However, with the advent of more potent anesthetic agents, it was soon realized that heavy medication before operation was neither desirable nor necessary. Administration of a mixture of depressant compounds, as an oral barbiturate2 and a narcotic, for preoperative sedation, and an ultrashort-acting barbiturate for induction, followed by administration of one of the modern anesthetics, frequently produced results entirely disproportionate to the requirements of the patient.
The pendulum of clinical thought then swung to the opposite end of the scale, and few or
Wallace G. PREANESTHETIC MEDICATION WITHOUT NARCOTICS: USE OF PROMETHAZINE AND A SYMPATHOMIMETIC AGENT IN 5,500 PATIENTS. JAMA. 1960;173(7):797–799. doi:10.1001/jama.1960.73020250014008f
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