SCOP
Premedicatia se refera la administrarea anumitor medicamente preoperator cu scop anxiolitic, sedativ, analgetic, antiemetic, de reducere a substantelor administrate ala inductie, preventia pneumoniei de aspiratie, scaderea cantitatii de secretii si preventia bradicardiei.
SUBSTANTE, CAI DE ADMINISTRARE
1. Anxiolitice si amnezice
- Benzodiazepine
- Diazepam OR/IM 0.2-0.5 mg/kg (10-20 mg)
- Lorazepam OR 0.05 mg/kg (2-4 mg), IM 0.03-0.05 mg/kg
- Midazolam IM 0.07-0.15 mg/kg, SL 0.1 mg/kg, Intranazal 0.2-0.3 mg/kg
- Agonisti receptori α2
- Clonidina 4 μg/kg
- Dexmedetomidina 4 μg/kg
2. Antiemetice
- Benzamide
- Metoclopramid IV 10 mg
- Antagonisti receptori serotonina 5-HT3
- Odansetron IV 4-8mg
- Granisetron IV 3 mg
- Butirofenone
- Droperidol
- Haloperidol
- Fenotiazine
- Clorpromazine
- Procloperazine
- Steroizi
- Dexametazona
- Antagonisti NK-1
- Aprepitat PO 40mg sau 80 mg
- Anticolinergice
- Scopolamina
- Antihistaminice
- Hidroxizina
- Dimenhidrinat
APFEL SCORE
| Factori de risc | Scor | |
| Sex | Masculin | 0 |
| Feminin | 1 | |
| Fumator | Da | 0 |
| Nu | 1 | |
| Istoric de rau de miscare | Da | 1 |
| Nu | 0 | |
| Utilizarea de opoide postoperator | Da | 1 |
| Nu | 0 | |
| Scor 2 - 1 sau 2 antiemetice Scor 3 - 4 - 3 antiemetice |
3. Antiacide
- Citrat de Sodiu OR 30 ml
- Inhibitori receptor H2
- Famotidina IV 20 mg
- Inhibitori pompa protoni
- Omeprazol OR 40 mg, IV 40 mg
- Pantoprazol IV 40 mg
4. Antiautonomice
- Anticolinergice
- Atropina
- Glicopirolat
- Antisimpaticomimetice
- β blocanti
5. Analgezice – preemtive analgezia
- NSAID
- Paracetamol
- Morfinice
6. Antihistamnice
- Difenilhidramina IV 30 mg
Administrarea orala a medicamentelor se va face cu 3-4 ore preoperator
IV = intravenos, OR = oral, IM = intramuscular