Premedication in elective adult general surgical patients at the Kenyatta National Hospital
Objective: To evaluate the practice of preoperative premedication in adult elective general surgical patients in Kenya. Design: Cross sectional study. Setting: Kenyatta National Hospital. Subjects: Seventy five adult elective general surgical patients. Results: Nineteen percent of patients had their premedication prescriptions written by staff from the department of anaesthesia while 81% of patients had their premedication prescriptions written by staff from surgery. Twentyone percent of patients got a preanaesthetic review while 79% did not. All patients had standard premedication with atropine 0.6 mg and pethidine 50 mg both given intramuscular. Five percent of patients had induction of anaesthesia half an hour after premedication, 27% had induction 1 hour post premedication while 68% of patients had induction over 2 hours post premedication. Eight percent of patients had hypertension, 4% renal failure, 3 % ischaemic heart disease, 3 % asthma, 3% had diabetes mellitus, and 28 % were elderly. Conclusion: The practice of premedication is poorly done at Kenyatta National Hospital. Most patients are given .atropine and pethidine as standard premedication regardless of primary pathology, concurrent disease, concurrent drug therapy, weight or age. There are no protocols/guidelines for premedication at the moment.