PRE-ANESTHETIC MEDICATIONS IN PATIENTS UNDERGOING EXPLORATORY LAPAROTOMY: RESULTS OF A CROSS-SECTIONAL STUDY

Anant Patil; Madhuri Kulkarni

doi:10.22159/ajpcr.2018.v11i3.23229

Authors

Anant Patil Department of Pharmacology, Dr. DY Patil Medical College, Navi Mumbai, Maharashtra, India.
Madhuri Kulkarni Department of Pharmacology, Government Medical College, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i3.23229

Keywords:

Drug utilization, Exploratory laparotomy, Pre-anesthetic medications

Abstract

Â Objective: The objective of this study was to understand the pattern of pre-anesthetic medication utilization in patients undergoing exploratory laparotomy.

Methods: In this cross-sectional study, we reviewed the records of patients who underwent exploratory laparotomy under general anesthesia. Descriptive data of the pre-anesthetic medications used in the patients are presented.

Results: A total of 49 patients with mean age of 65.85Â±34.15 years were included in the study. The study population was dominated by male patients (65.85%). Two major indications for exploratory laparotomy in the study population were perforation peritonitis 19 (38.77%) and intestinal obstruction 9 (18.37%). Ondansetron was used in all patients. metoclopramide and ranitidine were used in 48 (98%) patients each. Midazolam was given to 43 (87.8%) patients. A total of 41 (83.7%) patients received anticholinergic agent glycopyrrolate or atropine. Pentazocine and fentanyl were used in 39 (79.6%) and 10 (20.4%) patients, respectively.

Conclusion: Ondansetron, metoclopramide, ranitidine, midazolam, glycopyrrolate, and pentazocine were the major pre-anesthetic medications in patients undergoing exploratory laparotomy. Glycopyrrolate was the most preferred anticholinergic agent.

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References

Sheen MJ, Chang FL, Ho ST. Anesthetic premedication: New horizons of an old practice. Acta Anaesthesiol Taiwan 2014;52:134-42.

Suri Y. Evaluation of midazolam and diazepam for pre-operative sedation. Med J Armed Forces India 2000;56:287-92.

Wong HY, Fragen RJ, Dunn K. Dose-finding study of intramuscular midazolam preanesthetic medication in the elderly. Anesthesiology 1991;74:675-9.

Kain ZN, Caldwell-Andrews AA, Krivutza DM, Weinberg ME, Wang SM, Gaal D, et al. Trends in the practice of parental presence during induction of anesthesia and the use of preoperative sedative premedication in the united states, 1995-2002: Results of a follow-up national survey. Anesth Analg 2004;98:1252-9, table of contents.

Kongsrud F, Sponheim S. A comparison of atropine and glycopyrrolate in anaesthetic practice. Acta Anaesthesiol Scand 1982;26:620-5.

Rautakorpi P, Manner T, Kanto J. A survey of current usage of anticholinergic drugs in paediatric anaesthesia in finland. Acta Anaesthesiol Scand 1999;43:1057-9.

Rajendra N, Raj A, Madhusudhana R, Das P, Krishnamurthy D. Anaesthetic management of a patient with previous lobectomy posted for emergency modified radicle mastoidectomy. Int J Pharm Pharm Sci 2016;8:305-6.

Ali Q, Hu Y, Wang Y, Wu S, Qin Z, Wang J, et al. Pentazocine pretreatment suppresses fentanyl-induced cough. Pharmacol Rep 2010;62:747-50.

Wang N, Wang L, Gao Y, Zhou H, Wang J. Analgesic effect of preoperative pentazocine for laparoscopic cholecystectomy. Cureus 2016;8:e948.

Gupta P, Jain S. Postoperative nausea and vomiting prophylaxis: A comparative study of ondansetron, granisetron and granisetron and dexamethasone combination after modified radical mastectomy. Saudi J Anaesth 2014;8:S67-71.

Hong JY. Effects of metoclopramide and ranitidine on preoperative gastric contents in day-case surgery. Yonsei Med J 2006;47:315-8.

Kulkarni M, Patil A. A cross-sectional pharmacoepidemiological study of the utilization pattern of pre-anesthetic medications in major surgical procedures in a tertiary care hospital. Cureus 2017;9:e1344.

Jain R, Sharma R. A comparative study of effects of glycopyrrolate and ondansetron on nausea and vomiting in cesarean section under spinal anesthesia. Anesth Essays Res 2015;9:348-52.

Mihara T, Tojo K, Uchimoto K, Morita S, Goto T. Reevaluation of the effectiveness of ramosetron for preventing postoperative nausea and vomiting: A systematic review and meta-analysis. Anesth Analg 2013;117:329-39.

Fujii Y. Prophylaxis of postoperative nausea and vomiting in patients scheduled for breast surgery. Clin Drug Investig 2006;26:427-37.

Clark K, Lam LT, Gibson S, Currow D. The effect of ranitidine versus proton pump inhibitors on gastric secretions: A meta-analysis of randomized control trials. Anaesthesia 2009;64:652-7.

Cohen IT. An overview of the clinical use of ondansetron in preschool age children. Ther Clin Risk Manag 2007;3:333-9.

Altannak NF. Comparative LC-MS stability indicatind assays of ondansetron hydrochloride/naloxone hydrochloride and metoclopramide/naloxone hydrochloride used in palliative care. Int J Pharm Pharm Sci 2015;7:109-13.

Biswas P, Niveditha, Shivamurthy MC. A study to evaluate the pattern of preanaesthetic medication in various surgical specialties in a tertiary care hospital. Int J Pharm Sci Res 2014;5:2441-6.

Ruhaiyem ME, Alshehri AA, Saade M, Shobi TA, Zahoor H, Tawfeeq NA. Fear of going under general anesthesia: A cross-sectional study. Saudi J Anaesth 2016;10:317-21.

Ghali AM, Mahfouz AK, Al-Bahrani M. Preanesthetic medication in children: A comparison of intranasal dexmedetomidine versus oral midazolam. Saudi J Anaesth 2011;5:387-91.

Mirakhur RK. Preanaesthetic medication: A survey of current usage. J R Soc Med 1991;84:481-3.

Lim H, Doo AR, Son JS, Kim JW, Lee KJ, Kim DC, et al. Effects of intraoperative single bolus fentanyl administration and remifentanil infusion on postoperative nausea and vomiting. Korean J Anesthesiol 2016;69:51-6.