Preoperative Uses

Whereas tests (186) indicated that ampholytes were effective in skin cleansing for preoperative use, for wound cleansing, and as an antiseptic in the oral cavity (187), as well as other medical appHcations, the food and beverage industries have proved to be the principal employers of these compounds. Ampholytes are used as sanitizers and disinfectants, not as food preservatives. Low toxicity, absence of skin irritation, and noncorrosiveness, along with antimicrobial activity, has given ampholytes acceptance in dairies, meat plants, and the brewing and soft drink industries. These disinfectants have been manufactured and distributed in Europe and Japan, but not in the United States. 

Adults - For preoperative use, 50 mg administered with an appropriately reduced dose of narcotic or barbiturate and the required amount of a belladonna alkaloid. For postoperative use, 25 to 50 mg doses in adults. 

In a retrospective study, postoperative infectious complications were evaluated in 159 patients with inflammatory bowel disease undergoing elective surgery (317). Immunosuppression consisted of glucocorticoid monotherapy (n = 56), a glucocorticoid + azathioprine or mercaptopurine (n — 52), and neither a glucocorticoid nor azathioprine or mercaptopurine (n — 51). The adjusted odds ratios for any infection and major infections in patients who took glucocorticoid were 3.69 and 5.54 respectively, and in patients who took azathioprine or mercaptopurine 1.68 and 1.20. Thus, preoperative use of glucocorticoid in patients with inflammatory bowel disease increased the risk of postoperative infectious complications. 

Produces only mydriasis Preoperative uses Atropine... 

TA Ideblick, MM Lederman, MR Jacobs, RE Marcus. Preoperative use of povidone-iodine a prospective, randomized study. Clin Qrtheped Related Res. 213 211-215, 1986. 

A double-hlind, placebo-controlled study in 35 patients found that the preoperative use of fluoxetine 10 mg daily for 7 days reduced the analgesic effect of intravenous morphine given for postoperative dental pain. In contrast, a double-blind, crossover study in 15 healthy subjects found that a single 60-mg dose of fluoxetine slightly improved (by 3 to 8%) the analgesic effect (as assessed by dental electrical stimulation) of morphine sulfate in doses tailored to produce and maintain steady-state plasma levels of 15,30 and 60 nanograms/mL for 60 minutes. Plasma levels of morphine were not affected by fluoxetine, and morphine was found not to affect plasma levels of fluoxetine or norfluoxetine. The subjects experienced less nausea and drowsiness, but the psychomotor and respiratory depressant effects of morphine were not altered. ... 

Delay surgery if possible, preoperative use of nonparticulate antacid to reduce gastric acidity... 

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