Summary
Comparable groups of adult patients undergoing abdominal surgery were anaesthetized with methoxyflurane alone or supplemented with fentanyl. It was found that fentanyl reduced methoxyflurane requirements and that 4 L./min. O2 containing 0.34 per cent methoxyflurane in a semi-closed circle absorber system was almost invariably adequate for maintenance.
Patients were observed for one hour postoperatively and it was found that the supplemented group recovered consciousness more rapidly and were better able to respond to auditory commands. There was evidence that the startle reflex is active under certain circumstances during the early stages of recovery of consciousness. Fentanyl could be used satisfactorily to relieve distress in the postoperative period.
Interviews during the convalescent period established the absence of any experiences that might be termed hallucinatory. Only four out of forty patients had any recollection of their experiences in the recovery room.
Résumé
Des groupes semblables d’adultes subissant une opération abdominale ont été anesthésiés au méthoxyflurane seul ou additionné de fentanyl. On a observé que le fentanyl diminuait la dose requise de méthoxyflurane et qu’un débit de 4 litres d’oxygéne par minute contenant 0.34 pour cent de méthoxyflurane en circuit semi-fermé avec absorption de CO2 était presque toujours sufBsant pour le maintien de l’anesthésie.
Après l’opération, on a observé les malades durant une heure et on a trouvé que ceux qui avaient reçu du fentanyl devenaient conscients plus rapidement et pouvaient mieux répondre aux ordres qu’on leur donnait. II est apparu que le réflexe de la peur est actif dans certaines circonstances au début du retour de la conscience. Le fentanyl pourrait être utilisé avec satisfaction pour diminuer l’inquiétude durant la période postopératoire.
Durant la convalescence, nos conversations avec les malades ont prouvé qu’ils n’avaient souffert d’aucune hallucination. Quatre seulement sur quarante malades avaient gardé quelque souvenance de leur passage à la salle de réveil.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Gardocki, F. F. &Yelnoski, J. A Study of Some of the Pharmacological Actions of Fentanyl Citrate. Toxicol. & Appl. Pharmacol.6: 48 (1964).
Prys-Roberts, C. &Kelman, G. R. The Influence of Drugs Used in Neurolept Analgesia on Cardiovascular and Ventilatory Function. Brit. J. Anaesth.39: 134 (1967).
Fisher, Ronald A. &Yates, Frank. Statistical Tables for Biological, Agricultural and Medical Research. 3rd ed., London: Oliver & Boyd (1948).
Lasagna, Louis; vonFelsinger, John M.; &Beecher, Henry K. Drug-Induced Mood Changes in Man. J.A.M.A.157: 1006 (1955).
Eger, Edmund I., II & Brandstater, BernaRd. Solubility of Methoxyflurane in Rubber. Anesthesiology.24: 679 (1963).
Lambie, R. S. The Analgesia of Methoxyflurane. Canad. Anaesth. Soc. J.10: 469 (1963).
Dundee, John W. &Love, William J. Alteration in Response to Somatic Pain Associated with Anaesthesia: XIV. Effects of Subnarcotic Concentrations of Methoxyflurane. Brit. J. Anaesth.35: 301 (1963).
Nilsson, E. &Ingvar, D. H. Cerebral Blood Flow during Neurolept Analgesia in the Cat: A Preliminary Study. Acta anaesth. Scandinav.10: 47 (1965).
Mcintyre, J. W. R. Awareness during Anaesthesia: Preliminary Observations. Canad. Anaesth. Soc. J.13: 495 (1966).
Eckenhoff, James E.;Kneale, Dorothy H.; &Dripps, Robert D. The Incidence and Etiology of Postanaesthetic Excitement: A Clinical Survey. Anesthesiology.22: 667 (1961).
Egbert, L. D.;Lamdin, S. J.; &Hackett, T. P. Psychologic Factors Influencing Postoperative Narcotic Administration. Anesthesiology.28: 246 (1967).
Smessaert, Andre;Schehr, Claire A.; &Artusio, Joseph E. Observations in the Immediate Postanaesthesia Period. Brit. J. Anaesth.32: 181 (1960).
Egbert, L. D. Reduction of Postoperative Pain by Encouragement and Instruction of Patients: A Study of Doctor-Patient Relationships. New England J. Med.270: 825 (1964).
Dunbar, B. S.; Ovassapian; & Smith, Respiratory Effects of Anaesthesia with Innovar and Nitrous Oxide in Man. Anesthesiology.28: 245 (1967).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mcintyre, J.W.R., Miller, J.D.M. & Corkery, P. The use of fentanyl in the operative and postoperative period, with reference to methoxyflurane. Can. Anaes. Soc. J. 14, 470–482 (1967). https://doi.org/10.1007/BF03003808
Issue Date:
DOI: https://doi.org/10.1007/BF03003808