The Utility of Various Pre-anesthetic Medications Based on Type of General Anesthesia

Background: Premedication is used prior to surgery to reduce the adverse effects that might result from general anesthesia. Objective: This study was performed to examine the types and utility of various pre-anesthetic agents in 100 patients aged between 3 and 60 years who were admitted to Baladrooz General Hospital for different surgical operations during February (winter) and April (spring) 2021. Methods: A total of 62 patients received isoflurane, and 7 patients received sevoflurane, both by inhalational administration. The other 31 subjects were administered Marcaine (bupivacaine) by spinal anesthesia. Results: In this study, eight types of pre-anesthetic medication were administered prior to anesthesia, as follows: hydrocortisone (35 patients), metoclopramide (25 patients), atropine (13 patients), dexamethasone (12 patients), midazolam (7 patients), morphine (3 patients), ephedrine (3 patients), and fentanyl (2 patients). The most commonly used pre-anesthetic agent administered with isoflurane was hydrocortisone (37 patients), while the least used were fentanyl and morphine, which were administered to 3 patients each. Hydrocortisone was the premedication most often used (6 patients) with isoflurane, followed by dexamethasone, midazolam, and metoclopramide (5, 2, and 2 patients, respectively). The preanesthetic agent used most often with sevoflurane was hydrocortisone (6 patients), followed by dexamethasone (5 patients) and metoclopramide and midazolam (2 patients each). The premedication most commonly used with bupivacaine was metoclopramide (25 patients), while the least used was midazolam (2 patients). Conclusion: The study showed that several different pre-anesthetic drugs were used prior to anesthetic agents, which suggests that the selection of a pre-anesthetic drug depends on the risks that might be incurred when using a specific anesthetic drug.