Premedication

Premedication refers to the planned administration of medications before a medical, dental, or radiological procedure to improve safety, comfort, or outcome. The goals include reducing anxiety and memory of the event, providing analgesia, preventing nausea and vomiting, controlling autonomic responses, and preventing certain procedure-related complications such as infection or allergic reactions.

In surgical and perioperative settings, premedication commonly includes anxiolytics such as benzodiazepines (for example, midazolam) given orally or intravenously; analgesics or adjuncts such as opioids (for example, fentanyl) or acetaminophen; antiemetics (such as ondansetron or metoclopramide); and sometimes anticholinergics (like glycopyrrolate) to reduce secretions. Antibiotics may be given preoperatively to prevent surgical-site infection according to guidelines. For procedures with a risk of aspiration, airway and gastric protection strategies may be used. In patients with prior allergic or adverse reactions, antihistamines or alternative regimens may be included.

Premedication for imaging or contrast administration may involve corticosteroids and antihistamines to reduce the risk of a reaction in susceptible individuals. Pediatric and anxious patients may receive age-appropriate sedation, ranging from oral agents to short-acting IV sedatives, with monitoring.

Considerations include patient age, comorbidities, allergies, and potential drug interactions. Timing and route depend on the agent and procedure, and risks include oversedation, respiratory depression, hypotension, or delirium. Premedication is individualized and guided by clinical protocols. See also perioperative medicine, anesthesia, antibiotic prophylaxis, and PONV prophylaxis.