title: Anesthetic premedication: new horizons of an old practice.
abstract: The practice of anesthetic premedication embarked upon soon after ether and chloroform were introduced as general anesthetics in the middle of the 19(th) century. By applying opioids and anticholinergics before surgery, the surgical patients could achieve a less anxious state, and more importantly, they would acquire a smoother course during the tedious and dangerous induction stage. Premedication with opioids and anticholinergics was not a routine practice in the 20(th) century when intravenous anesthetics were primarily used as induction agents that significantly shorten the induction time. The current practice of anesthetic premedication has evolved into a generalized scheme that incorporates several aspects of patient care: decreasing preoperative anxiety, dampening intraoperative noxious stimulus and its associated neuroendocrinological changes, and minimizing postoperative adverse effects of anesthesia and surgery. Rational use of premedication in modern anesthesia practice should be justified by individual needs, the types of surgery, and the anesthetic agents and techniques used. In this article, we will provide our readers with updated information about premedication of surgical patients with a focus on the recent application of second generation serotonin type 3 antagonist, antidepressants, and anticonvulsants.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC; Department of Anesthesiology, National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address: mkjsheen@cgmh.org.tw.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sheen
authors.affiliation: Department of Anesthesiology, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Anesthesiology, Tri-Service General Hospital at Songshan, Taipei, Taiwan, ROC.
authors.forename: Fang-Lin
authors.initials: FL
authors.lastname: Chang
authors.affiliation: Department of Anesthesiology, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Shung-Tai
authors.initials: ST
authors.lastname: Ho
mesh_terms: D001007:Anxiety / Q000517:prevention & control; D005744:Gastric Acid / Q000378:metabolism; D006801:Humans; D010149:Postoperative Pain / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D011229:Preanesthetic Medication; D011537:Pruritus / Q000517:prevention & control; D012768:Shivering
keywords: anticonvulsants; antidepressive agents; antiemetics; benzodiazepines; clonidine; dexmedetomidine; midazolam; neurokinin 1 receptor antagonists; premedication; serotonin 5-HT3 receptor antagonists