Abstract
We evaluated the usefulness of eptazocine hydrobromide as an adjuvant in patients receiving antipsychotics for long periods. Patients anesthetized with enflurane alone (enflurane group, n=11), were compared with those anesthetized with enflurane and eptazocine hydrobromide 1 mg·kg−1 (eptazocine group, n=10). The mean daily dose of the antipsychotics, converted into the amount of chlorpromazine, was 345 mg in the eptazocine group and 366 mg in the enflurane group. The duration of antipsychotic medication was 14 years in the eptazocine group and 17 years in the enflurane group. The maintenance concentration of enflurane was 0.37% in the eptazocine group and 0.67% in the enflurane group, being significantly lower in the former group. The interval between the termination of operation and removal of the endotracheal tube was slightly shorter in the eptazocine group. The discriminant function of circulatory stability obtained from the measurement of systolic blood pressure and heart rate during anesthesia in the eptazocine group was 481, being significantly lower than 539 in the enflurane group. Both absolute and relative instabilities of systolic blood pressure and heart rate were slightly smaller in the eptazocine group. No side effects associated with eptazocine hydrobromide administration were observed. These results suggest the safety and usefulness of this analgesic in the anesthetic management of patients receiving long-term antipsychotic medication.
Similar content being viewed by others
References
Delay J, Deniker P, Harl JM: Traitment de etats d’excitation et agitation par une methode medicatmenteuse derivede l’hibernotherapie. Ann Med Phychol 110:267–272, 1952
Matsuki A, Oyama T, Izai S, et al: Excessive mortality in Schizophrenic patients on chronic phenothiazines treatment. Agressologie 13:407–418, 1972
Nabeshima T, Matsuno K, Kamei H, et al: The interaction of eptazocine, a novel analgesic, with opioid receptors. Res Comm Chem Path Pharmacol 48:173–181, 1985
Nozawa T, Ohno T, Mizuhashi T, et al: Pharmacological studies of l-1, 4-dimethyl-10-hydroxy-2, 3, 4, 5, 6, 7-hexahydro-1, 6-methano-1H-4-benzazonine (1-ST-2121) (3) Effects on the respiratory and circulatory systems. Pharmacometrics 20:127–134, 1980
Nozawa T, Ohno T, Mizuhashi T, et al: Pharmacological studies of l-1, 4-dimethyl-10-hydroxy-2, 3, 4, 5, 6, 7-hexahydro-1, 6-methano-1H-4-benzazonine (1-ST-2121) (4) Effects on the autonomic nervous system. Pharmacometrics 20:135–142, 1980
Momose T, Ito K, Enomoto N, et al: A comparison between pentazocine and buprenorphine in analgesic supplemented anesthesia. Masui (Jpn J Anesthesiol) 30:1053–1061, 1981
Harada J, Takakura K, Goto Y, et al: A comparison of eptazocine with buprenorphine, pentazocine and butorphanol in neuroleptanesthesia-evaluation of hemodynamic stability. J Jpn Soc Clin Anesth 10:26–33, 1990
Davis JM: Organic therapies: Antipsychotic drugs, Comprehensive Textbook of Psychiatry. Edited by AM Freedman. Baltimore, Williams and Wilkins, 1980, pp. 2257–2289
Leestma JE, Koenig KU: Sudden death and phenothiazines. Arch Gen Psychiat 18:137–148, 1968
Moore MT, Book H: Sudden death in phenothiazine therapy. Psychiat Q 44:389–402, 1970
Ketai R, Matthewa J, Mozdzen JRJJ: Sudden death in a patient taking haloperidol. Am J Psychia 136:112–113, 1979
Wendokos MH: Psychiatric patients and sudden death. Am J Psychiatry 137:1627–1628, 1980
Matsuki A, Kimura K, Meda A, et al: Anesthetic experience with 62 schizophrenic patients on chronic antipsychotic drugs. Masui (Jpn J Anesthesiol) 36:1808–1812, 1987
Matsuki A, Ishihara H, Satoh H, et al: The anesthetic management of schizophrenic patients. J Jpn Soc Clin Anesth 8:368–373, 1988
Allsop P, Twigley AJ: The neuroleptic malignant syndrome. Anaesthesia 42:49–53, 1987
Nozawa T, Ohno T, Mizuhashi T, et al: Pharmacological studies of l-1, 4-dimethyl-10-hydroxy-2, 3, 4, 5, 6, 7-hexahydro-1, 6-methano-1H-4-benzazonine (1-ST-2121) (1) Analgesic activity. pharmacometrics 19:973–982, 1980
Morioka Y, Atomi Y, Kashii A, et al: Clinical evaluation of eptazocine on postoperative pain — A double blind study in comparison with pentazocine. Cli Eval 13:791–812, 1985
Morioka Y, Tomiyama J, Tsuchiya S, et al: A comparative study on the analgesic effect of eptazocine and pentazocine on cancer pain. Basic pharmacol therapeut 10:6853–6871, 1982
Takahashi S, Katagai H, Takazawa T, et al: Effects of modified NLA with droperidol and eptazocine and surgery on pituitary-adrenocortical function in man. Masui (Jpn J Anestheesiol) 38:523–530, 1989
Miller RD: Anesthesia. Edited by Churchill Livinstone. New York, 1990, pp. 1010–1019
Author information
Authors and Affiliations
About this article
Cite this article
Mizobe, T., Oda, Y., Natsuyama, T. et al. Anesthetic management with eptazocine hydrobromide in patients receiving long-term antipsychotic medication. J Anesth 6, 21–27 (1992). https://doi.org/10.1007/s0054020060021
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s0054020060021