To premed or not to premed

National Anaesthesia Day is our opportunity as a profession to make contact with the public and provide them with a better understanding of what exactly it is that we do. Equally, it is also a valuable time to explore the public's perceptions and views on various aspects of our day-to-day practices. During the last National Anaesthesia Day, we conducted a survey at the Oxford Radcliffe Hospitals to look at people's experiences and understanding of the use of premedication. Members of the general public who viewed the National Anaesthesia day displays were asked to complete a 4-point questionnaire about premedication. The questions asked included. When you have an anaesthetic for an operation do you expect to be given a premed before you go to the operating theatre? What do you think premeds are given for? Have you ever been given a premed before an operation and wished you had not? Have you ever had an operation without being given a premed when you wished one had been prescribed? We had 92 responses to our questionnaire. These were completed by a cross section of the public including patients, outpatients, visiting relatives and friends and members of staff (non- theatre staff). The majority (68%) indicated that they expected to be given a premed before an operation; 20% were undecided and only 12% did not expect to have a premed. The public were asked to indicate from a list of options the possible reasons for having a premed. The responses to this question are provided in Table 2. Of those people who had previously had an operation, only 13% who were given a premed wished they had not been; while 18% of those who had been to theatre without being prescribed a premed indicated that they would like to have had one. There are a wide variety of indications for various drugs to be given prior to induction of anaesthesia and the commencement of surgery. Premedication is frequently the part of the anaesthetic procedure that people will experience and remember as they wait on the ward for their operation; therefore, it seems likely that they will have some opinions about its use. This brief survey indicates that this is the case and that there is an expectation on the part of the public and hence patients for premedication to be given. We should therefore include a full discussion about premedication with all patients, whether it is our intention to prescribe it or not. Our survey showed that most patients knew that anxiolysis and sedation are key reasons for prescribing premedication but far fewer were aware of the other, often more frequent reasons for giving premedication. It is important that patients are made aware of the nature of the premedication that has been prescribed for them so that they are not disappointed by the lack of sedation experienced following premed of, for example, ranitidine and metoclopramide. Whether to prescribe or not to prescribe a premed depends on the individual patient, anaesthetist, medical and surgical factors; however, it is worth remembering that patients have their own expectations and views on the subject.