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Preanesthetic Medication Old and New Concepts

AMA Arch Surg. 1959;79(6):976-980. doi:10.1001/archsurg.1959.04320120118013.
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Premedication is an old idea. Claude Bernard suggested using morphine before anesthesia to facilitate induction. Misconceptions are prevalent concerning premedication. Often it is ordered empirically without rational basis. This exhibit indicates accepted uses and common misconceptions.

Why Give Premedication?  Preanesthetic medication is necessary (1) for psychic sedation primarily, (2) to minimize secretions, (3) to fortify impotent anesthetics, and (4) as prophylaxis for suppression of vagal and other autonomic reflex activity.

Summary  Premedication is part of the anesthetic. The desired goal is tranquility and amnesia without loss of consciousness. The narcotics combined with belladonna alkaloids still remain the most reliable and versatile agents for premedication.

What Are the Criteria for Selection of Premedication?  Premedication is part of the anesthetic. Drugs and methods must be individualized for a particular patient and technique of anesthesia. The anesthetist is best qualified to prescribe it. It should be his prerogative to select it.

What Drugs 


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