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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/09/03 20:39:11」(JST)

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Premedication refer to a drug treatment given to a patient before a (surgical or invasive) medical procedure. These drugs are typically sedative or analgesic.

Premedication before chemotherapy for cancer often refers to special drug regimens (usually 2 or more drugs, e.g. dexamethasone, diphenhydramine and omeprazole) given to a patient minutes to hours before the chemotherapy to avert side effects or hypersensitivity reactions (i.e. allergic reactions).

Melatonin has been found to be effective as a premedication in both adults and children due to its pharmacological properties of hypnotic, antinociceptive and anticonvulsant which produce effective anxiolosis and sedation. Unlike midazolam melatonin does not impair psychomotor skills or adversely affect the quality of recovery. It has a faster recovery time compared to midazolam and has a reduced incidence of post-operative excitement and results in a reduction in dose required of propofol and thiopental.^[1]

Midazolam is effective in children in reducing anxiety associated with separation from parents and induction of anesthesia.^[2] Sufentanil is also sometimes used as a premedication. Clonidine is becoming increasingly popular as a premedication for children. One drawback of clonidine is that it can take up to 45 minutes to take full effect.^[3] In children, clonidine has been found to be equal to and possibly superior to benzodiazepines as a premedication. It has a more favourable side effect profile. It also reduces the need for an induction agent. It improves post-operative pain relief, is better at inducing sedation at induction, reduces agitated emergence, reduces shivering and post-operative nausea and vomiting and reduces post-operative delirium associated with sevoflurane anaesthesia. Benzodiazepines such as midazolam are more commonly used due largely to a lack of a marketing effort by the pharmaceutical companies. As a result, clonidine is becoming increasingly popular with anesthesiologists.^[4]^[5] Dexmedetomidine and atypical antipsychotic agents are other premedications which are used particularly in very uncooperative children.^[6]

Non-drug interventions for children include playing relaxing music, massages, reducing noise and controlling light to maintain the sleep wake cycle.^[7] Other non-pharmacological options for children who refuse or cannot tolerate premedication include clown doctors; low sensory stimulation and hand-held video games may also help reduce anxiety during induction of general anesthesia.^[8]^{[needs update]}

References

^ Naguib, M.; Gottumukkala, V.; Goldstein, PA. (Jan 2007). "Melatonin and anesthesia: a clinical perspective.". J Pineal Res. 42 (1): 12–21. doi:10.1111/j.1600-079X.2006.00384.x. PMID 17198534.
^ Cox, RG.; Nemish, U.; Ewen, A.; Crowe, MJ. (Dec 2006). "Evidence-based clinical update: does premedication with oral midazolam lead to improved behavioural outcomes in children?". Can J Anaesth. 53 (12): 1213–9. doi:10.1007/BF03021583. PMID 17142656.
^ Rosenbaum, A.; Kain, ZN.; Larsson, P.; Lönnqvist, PA.; Wolf, AR. (Sep 2009). "The place of premedication in pediatric practice.". Paediatr Anaesth. 19 (9): 817–28. doi:10.1111/j.1460-9592.2009.03114.x. PMID 19691689.
^ Bergendahl, H.; Lönnqvist, PA.; Eksborg, S. (Feb 2006). "Clonidine in paediatric anaesthesia: review of the literature and comparison with benzodiazepines for premedication.". Acta Anaesthesiol Scand. 50 (2): 135–43. doi:10.1111/j.1399-6576.2006.00940.x. PMID 16430532.
^ Dahmani, S.; Brasher, C.; Stany, I.; Golmard, J.; Skhiri, A.; Bruneau, B.; Nivoche, Y.; Constant, I.; Murat, I. (Jan 2010). "Premedication with clonidine is superior to benzodiazepines. A meta analysis of published studies". Acta Anaesthesiol Scand. 54 (4): 397–402. doi:10.1111/j.1399-6576.2009.02207.x. PMID 20085541.
^ Bozkurt, P. (Jun 2007). "Premedication of the pediatric patient - anesthesia for the uncooperative child". Curr Opin Anaesthesiol. 20 (3): 211–5. doi:10.1097/ACO.0b013e328105e0dd. PMID 17479023.
^ Mencía, SB.; López-Herce, JC.; Freddi, N. (May 2007). "Analgesia and sedation in children: practical approach for the most frequent situations". J Pediatr (Rio J). 83 (2 Suppl): S71–82. doi:10.2223/JPED.1625. PMID 17530139.
^ Yip, P.; Middleton, P.; Cyna, AM.; Carlyle, AV. (2009). Cyna, Allan M, ed. "Non-pharmacological interventions for assisting the induction of anaesthesia in children" (PDF). Cochrane Database Syst Rev (3): CD006447. doi:10.1002/14651858.CD006447.pub2. PMID 19588390.

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English Journal

Play distraction versus pharmacological treatment to reduce anxiety levels in children undergoing day surgery: a randomized controlled non-inferiority trial.

Al-Yateem N1, Brenner M2, Shorrab AA3, Docherty C1.
Child: care, health and development.Child Care Health Dev.2016 Jul;42(4):572-81. doi: 10.1111/cch.12343. Epub 2016 Apr 14.
BACKGROUND: Perioperative experience can be one of the most distressful experiences in a child's life if not managed properly by healthcare professionals. Its consequences can extend well beyond surgery and recovery into the child's future life. Healthcare professionals have a responsibility to decr
PMID 27080806

A multicentre, prospective, randomised, blinded clinical trial to compare some perioperative effects of buprenorphine or butorphanol premedication before equine elective general anaesthesia and surgery.

Taylor PM1, Hoare HR2, de Vries A3, Love EJ4, Coumbe KM5, White KL2, Murrell JC6.
Equine veterinary journal.Equine Vet J.2016 Jul;48(4):442-50. doi: 10.1111/evj.12442. Epub 2015 Jun 10.
REASONS FOR PERFORMING STUDY: Buprenorphine, a μ-agonist opioid, has recently been licensed for equine use, but butorphanol, a κ-agonist opioid, is more commonly used in horses. The effect of the 2 opioids has not previously been compared in a large clinical study.OBJECTIVES: To compare post opera
PMID 25772950

Radiation dose reduction in paediatric coronary computed tomography: assessment of effective dose and image quality.

Habib Geryes B1, Calmon R2,3, Khraiche D4,3, Boddaert N2,3, Bonnet D4,3, Raimondi F5,6,7.
European radiology.Eur Radiol.2016 Jul;26(7):2030-8. doi: 10.1007/s00330-015-4032-5. Epub 2015 Oct 3.
OBJECTIVES: To assess the impact of different protocols on radiation dose and image quality for paediatric coronary computed tomography (cCT).MATERIALS AND METHODS: From January-2012 to June-2014, 140 children who underwent cCT on a 64-slice scanner were included. Two consecutive changes in imaging
PMID 26433957