Premedication of children with papaveretum-hyoscine. The effect of varying dosage schemes.

Papaveretum-hyoscine is a popular premedication for children but there is no agreement as to dosage. Four dosage schemes were compared in a double blind trial on children undergoing adenotonsillectomy in an attempt to determine the optimum method of using the drug mixture. No real difference in behaviour and co-operation in the anaesthetic room could be detected between any of the dosage schemes. The highest dosage is associated with excessive salivary suppression, increase in violent restlessness, postoperative vomiting and respiratory depression. One instance is reported of a near fatality due to respiratory depression following the postoperative opiate. The only advantage of the highest dosage is some increase of amnesia for the intravenous induction. For these reasons the lowest of the four dosage schemes used in the trial is recommended, namely, 2 mg/stone of papaveretum (with 0.04 mg/stone of hyoscine). This can be regarded as the normal adult dose scaled down in proportion to the weight of the child, and there is little justification for the use of stronger dosages as premedication for children.