Why do we Premedicate?

Question 1

What is pre-medication?

Answer 1

Combination of or single drug given prior to anaesthesia
Common component of most anaesthetics

Question 2

Why do we pre-medicate?

Answer 2

Balanced anaesthesia
Allows for smaller doses of each drug - reduced detrimental side effects
Reduces stress
Initiates sedation - easier to place IV cannula
Provides analgesia for painful procedures
Improves recovery

Question 3

How do we know which drugs to use?

Answer 3

Consider patients history
Physical exam
ASA category
Patient temperament
Procedure lenghth/pain
Drug characteristics
Licensing
Availability of drug

Question 4

What is nociception?

Answer 4

Physiological response to noxious stimuli

Question 5

How do patients undergo nociception under GA?

Answer 5

Synaptic transmission from periphery to spinal cord/brain is not completely blocked by anaesthetic
Animal still responds to stimulus but are unaware
DO NOT feel pain

Question 6

Why do we use analgesia in premedication?

Answer 6

pre-emptive approach (for painful surgeries)
avoid post-op pain
Aims to block transmission through peri-operative period
To reduce acute pain after tissue injury
Prevent pathological modulation of CNS
Prevents development of hyperalgesia/chronic pain state

Question 7

Why is chronic pain bad?

Answer 7

Slows wound healing
Increased cortisol
Increased proinflammatory cytokines