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Patients' Expectations and Acceptance of the Effects of the Drugs Given Before Anaesthesia: Comparison of Light and Amnesic Premedication
Author(s) -
Korttila K.,
Aromaa U.,
Tammisto T.
Publication year - 1981
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1981.tb01670.x
Subject(s) - premedication , medicine , lorazepam , anesthesia , pethidine , diazepam , general anaesthesia , amnesia , psychiatry , analgesic
Patients (130) scheduled for elective general surgery under balanced general anaesthesia were interviewed on the day before operation and asked whether they wanted a light premedication allowing them to remember all events before and after surgery or whether they wanted a potent premedication rendering them amnesic for the events before and after operation. Regardless of their preferences, the patients were given 1 mg/kgofpethidine; 12.5 to 50 mg of promethazine, plus 0.14 mg/kg oxycodone; or 0.05 mg/kg of lorazepam; and 0.01 mg/kg of atropine intramuscularly in random fashion as preanaesthetic medication before operation. On the first postoperative day, patients were questioned again about their opinions of the premedication. Most patients wanted light (53%) or moderate (22%) premedication, and only 5% wanted to receive amnesic premedication. Assessments of degree of fatigue and apprehension were similar after each premedication when assessed before operation. Sixty‐seven and 60% of the patients receiving lorazepam did not remember insertion of the i.v. needle before induction of anaesthesia or the stay in the recovery room, respectively (P<0.01 vs. other groups), whereas most of the patients given pethidine or oxycodone recalled the events before and after operation. Almost all the patients who both expected and received a light (91% acceptance) or an amnesic (100% acceptance) premedication accepted it. However, only 58% of patients who expected to be given a light but received an amnesic premedication were satisfied with it, whereas 89% of patients who expected an amnesic but received a light premedication accepted it. It is concluded that patients' opinions on the potency and capacity of preanaesthetic medication to produce amnesic action should be taken into account in routine clinical work. Administration of a potent, amnesic premedication is indicated only if patients prefer it to light premedication.