Summary
The study was designed to evaluate the usefulness of neurolept-anaesthesia (NLA) for major abdominal and thoracic surgery. A standard technique, in which thiopentone-tubocurarine-nitrous oxide-oxygen was supplemented with intravenous levorphanol, was compared with four other techniques involving the use of various combinations of the drugs commonly used inNLA, i.e. fentanyl and droperidol.
Identical cases, anaesthetised with different techniques, were analysed by sequential analysis.
Induction was slow with neuroleptic drugs and in 28 per cent of cases marked difficulty was experienced in ventilating the patient. Cardiovascular changes at induction were similar with each of the techniques.
There was less sweating and movement of the patients using neuroleptic techniques but heart rate and blood pressure were more stable during maintenance of anaesthesia when levorphanol was used.
In the postoperative period, the onset of pain was delayed and the need for analgesics less in patients given levorphanol. The authors conclude that neuroleptanaesthesia has no advantages over conventional anaesthesia, so far as major surgery is concerned.
Résumé
La technique anesthésique standard utilisée par les auteurs pour la chirurgie majeure consiste en une induction au thiopentone complétée par du protoxyde d’azote-oxygène et du levorphanol, en administrant de fortes doses de tubocurarine pour assurer le relâchement musculaire. On a comparé cette technique avec une autre où l’on utilise l’Innovar ’ pour l’induction et soit encore l’innovar, soit le fentanyl seul comme complément au protoxyde d’azote. Dans cette étude on n’a pas pu confirmer les prétendus avantages de cette dernière forme de neuroleptanalgésie. Avec le thiopentone comme agent d’induction, le fentanyl s’est montré inférieur au levorphanol comme complément d’induction, et même lorsqu’on y ajouté une seule dose de dropéridol, on n’a pas eu de meilleurs résultats qu’avec la technique standard.
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McDowell, S.A., Dundee, J.W. Neurolept anaesthesia: A comparison with a conventional technique for major surgery. Canad. Anaesth. Soc. J. 18, 541–551 (1971). https://doi.org/10.1007/BF03026016
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DOI: https://doi.org/10.1007/BF03026016