Use of intramuscular Midazolam, Meperidine and Morphine combined with Atropine in adult premedication

Objective: We aimed to compare the effects of midazolam, meperidine and morphine combined with atropine that used in adult premedication intramuscularly (im) on hemodynamics changes, sedation and anxiety.
Study Design: 200 patients with 17-74 years of age range from ASA I-II groups having elective operation were involved into study. Patients were divided into 4 equal groups with 50 persons, randomly. We determined the four groups as Group 1 (midazolam 0.07 mglkg+atropine 0.01 mg/kg), Group 2 (meperidine 1 mglkg+atropine 0. 01 mg/kg), Group 3 (morphine 0.01 mglkg+atropine 0.01 mg/kg) and group 4 (atropine 0.01 mg/kg). Drugs were given intramuscularly 45-60 minutes before operation. Sedation score, anxiety score, heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR) and adverse effects were recorded.
Results: Sedation and anxiety scores siginificantly decreased in all groups except for Group 4 (p<0.05). HR was increased significantly in these groups except for Group 3 (p<0.05). MAP in Group 3, RR in Group 1 and 3 were siginificantly decreased (p<0.05). In all groups, the most frequently seen adverse effect was the dry mouth.
Conclusions: We determined that im midazolam, meperidin and morphine were sufficient to abolish anxiety in adult premedication. We thought that the appropriate use of atropine should be whenever indication was present.

Eriþkin premedikasyonunda; Atropin ile kombine Midazolam, Meperidin ve Morfinin intramasküler kullanýmý

Amaç: Midazolam, meperidin ve morfinin atropinle kombine olarak eriþkin premedikasyonunda intramüsküler (im) kullanýmýnýn hemodinamik deðiþiklikler, sedasyon ve anksiyete üzerine etkilerini karþýlaþtýrmayý amaçladýk.
Gereç ve Yöntem: ASA-II grubundan, 17-74 yaþ arasý elektif operasyon geçirecek 200 hasta çalýþmaya alýndý. Hastalar rastgele 50 kiþilik dört eþit gruba ayrýldý. Grup 1 (midazolam 0. 07 mg/kg + atropin 0.01 mg/kg), grup 2 (meperidin 1 mg/kg+atropin 0.01 mg/kg), grup 3 (morfin 0.1 mg/kg+atropin 0. 01 mg/kg), grup 4 (atropin 0.01 mg/kg) olarak belirlendi, ilaçlar operasyondan 45-60 dk. önce im uygulandý. Sedasyon skoru, anksiyete skoru, kalp atým hýzý (OAB), solunum sayýsý (SS) ve yan etkiler kaydedildi.
Bulgular: Grup 4 dýþýndaki gruplarda sedasyon ve anksiyete skorlarý anlamlý olarak azaldý (p<0.05). KAH grup 3 dýþýndaki üç grupta anlamlý olarak arttý (p<0.05). O AB grup 3’de, SS ise grup 1 ve 3’de anlamlý olarak azaldý(p<0.05). Bütün gruplarda en sýk görülen yan etki aðýz kuruluðu oldu.
Sonuçlar: Eriþkin premedikasyonunda anksiyeteyi gidermede im midazolam, meperidin ve morfinin yeterli etkinlikte olduklarým tespit ettik. Atropinin ise endikasyon olduðunda kullanýlmasýnýn doðru olacaðýný düþündük.