PREOPERATIVE SEDATION AND PRODUCTION OF A QUIESCENT STATE IN CHILDREN

• Previous experience with 3,000 surgical cases showed that meperidine and promethazine together were an extremely satisfactory combination for use as premedication for anesthesia. A method for administering them was evolved from this experience and was applied uniformly in a special series of 200 consecutive pediatric cases. Promethazine, 1.1 mg. per kilogram of body weight (0.5 mg. per pound), was injected intramuscularly 60 to 90 minutes before induction of anesthesia; meperidine in the same dosage was given intramuscularly 30 to 60 minutes before induction. Scopolamine in doses ranging from 0.1 to 0.43 mg. (1/650 to 1/150 grains) according to the body weight was given with the meperidine. This premedication sufficed to eliminate all signs of dread in 93 % of the children, suppressed motor activity in 92%, induced sound sleep in 12%, and eliminated all reactions to the environment in 80%. The over-all effect, in the opinion of the anesthesiologist, was that induction was facilitated in 80%, unaffected in 17% and delayed in 3%. There was no cyanosis or vascular depression in any case, and only one of the 200 patients vomited. Since a parallel series permitting comparison with other types of premedication remains to be completed, the authors regard this as a preliminary report.