Premedication for surgery: a survey of Australian practice

Objective: To survey anaesthetists' premedication practices for adult surgical patients. Methods: With institutional approval, a survey questionnaire was given to anaesthetists in Western Australia during January-May 1995. The survey was anonymous and contained 16 questions. Seven responses were recorded using an anchored, 100 mm visual analogue scale (VAS). Two clinical scenarios were described and respondents were asked to detail their use of premedication drugs. Participants: Consultant and trainee anaesthetists practising in Western Australia. Results: Completed forms were returned by 107 anaesthetists. Respondents were aged 27-63 yr (mean age 42 +/- 9 yr) and were grouped by staff position (77% consultant, 23% trainee), sex (85% male) and years of practice. In general, inpatients were visited on the day before surgery (VAS=86) but not always questioned about their anxiety (VAS=56). Anaesthetists believed that premedication itself was somewhat important (VAS=67) and that patients expect premedication drugs to be used more often than not (VAS=68). Anaesthetists considered the route of administration to be unimportant (VAS=31). Patients undergoing day case surgery had an even chance of receiving no premedication whereas inpatients were more likely to receive premedication. The main aims of premedication were considered to be anxiolysis (71%), to make the anesthetic experience more pleasant for the patient (50%) and to reduce aspiration risk (39%). The preferred drug for premedication was temazepam. Conclusion: Premedication remains a popular practice although there are diverse opinions on its aims. (author abstract)