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The child's fear of injections coupled with the concern that the psychologic advantage of intramuscular premedication may be all or in part negated by the trauma of injections prompted the authors to seek an oral preanesthetic medication to safely and reliably replace injections. The authors describe the results of a prospective, randomized, double-blind study comparing the pharmacologic effects of oral versus injectable preanesthetic medication in 67 healthy pediatric inpatients older than 1 yr. Children given the oral medication (meperidine 3.0 mg/kg, pentobarbital 4.0 mg/kg) were significantly more drowsy in the holding area (P less than 0.001) and more cooperative at the time of induction of anesthesia (P less than 0.01) than the children given intramuscular medication (morphine 0.1 mg/kg, pentobarbital 4.0 mg/kg). There were no other differences between the two groups. These data demonstrate that oral preanesthetic medication can be as or more effective compared with intramuscular medication in producing the desired effects without adverse side effects. As a result of this study, the benefits of preanesthetic medication can now be achieved in nearly all surgical patients without injections.

Comparison of Oral and Intramuscular Preanesthetic Medication for Pediatric Inpatient Surgery