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New Uses for Agonist-Antagonists in Anesthesia

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Anesthesiology: Today and Tomorrow

Part of the book series: Developments in Critical Care Medicine and Anaesthesiology ((DCCA,volume 9))

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Abstract

The introduction of neuroleptanalgesia by De Castro and Mundeleer opened a new epoch in anesthesiology, since many of the side effects associated with the deep planes of inhalational anesthetics were obviated. The separate and appropriate dosing of droperidol and fentanyl allowed the safe conduct of surgery with minimal adverse endocrine and metabolic sequelae. The introduction of benzodiazepines provided another safe, alternate technique; ataract-analgesia with the combination of diazepam-fentanyl or flunitrazepam-fentanyl has been used during the past two decades. The introduction of the highly specific narcotic antagonist, naloxone, further enhanced the safety of neuroleptor ataract-analgesia, since reversal of the respiratory depression could be carried out with safety.

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References

  1. Bellville JW, Green J. The respiratory and subjective effects of pentazocine. Clin Pharmacol Therap 6: 152, 1965.

    CAS  Google Scholar 

  2. Bellville JW, Forrest WH, Brown BW. Clinical and statistical methodology for cooperative clinical assays of analgesics. Clin Pharmacol Therap 9: 290, 1968.

    CAS  Google Scholar 

  3. Sadove MS, Balagot RC. Pentazocine: A new nonaddicting analgesic. J Am Med Assoc 193: 887, 1965.

    CAS  Google Scholar 

  4. Tammisto T, Lahdensuu M, Fock G. Pentazocine as a supplement in anesthesia. A clinical comparison of pethidine, fentanyl, and pentazocine in nitrous-oxide- oxygen-relaxant anesthesia. Ann Chir Gynaec Fenn 56: 319, 1967.

    PubMed  CAS  Google Scholar 

  5. Dundee JW, Clarke RSJ, Loan WB, Hamilton RC. Clinical studies with opiate antagonists. Brit J Anaesth 39: 88, 1967.

    Google Scholar 

  6. Alderman EL, Barry WH, Graham AF, Harrison DC. Hemodynamic effects of morphine and pentazocine differ in cardiac patients. New Engl J Med 287: 623, 1972.

    Article  PubMed  CAS  Google Scholar 

  7. De Castro J, Viars P. Utilisation pratique des analgesiques centraux en anesthesie et reanimation. Ars Medici Sep 23: 101, 1968.

    Google Scholar 

  8. Dobkin AB, Israel JS, Pislock PA. The metabolic response to pentazocine as a supplement to balanced anaesthesia for major abdominal surgery. Canad Anaesth Soc J 17: 485, 1970.

    Article  PubMed  CAS  Google Scholar 

  9. Payne JP. The clinical pharmacology of pentazocine. Drugs 5: 1, 1973.

    Article  PubMed  CAS  Google Scholar 

  10. Ritzow H. Reversability of the fentanyl- and morphine-induced respiratory depression by morphine antagonists. Anaesthetist 22: 425, 1973.

    CAS  Google Scholar 

  11. Aldrete JA, Clapp HW, Fishman J, O’Higgins JW. Pentazepam: A supplementary agent. Anesth Analg 50: 498, 1971.

    PubMed  CAS  Google Scholar 

  12. Aldrete JA. Respiratory changes during laryngoscopy: Influence of anesthetic technique. ORL Digest 33: 29, 1971.

    Google Scholar 

  13. Keeri-Szanto M, Pomeroy JR. Atmospheric pollution and pentazocine metabolism. Lancet 1: 947, 1971.

    Article  PubMed  CAS  Google Scholar 

  14. Keeri-Szanto M. Drug consumption during thiopentone-nitrous oxide-relaxant anesthesia: The preparation and interpretation of time/dose curves. Brit J Anaesth 32: 415, 1960.

    Article  Google Scholar 

  15. Schoenfeld A, Goldman JA, Levy E. Pentazoncine and diazepam analgesia for minor gynaecological operations. Br J Anaesth 46: 385, 1974.

    Article  PubMed  CAS  Google Scholar 

  16. Aldrete JA, Tan ST, Carrow DJ, Watts MK. “Pentazepam” (pentazocine-diazepam) supplementing local analgesia for laparascopic sterilization. Anesth Analg 55: 177, 1976.

    Article  PubMed  CAS  Google Scholar 

  17. Jourde J, Peri G, Menes H et al. The value of associating diazepam and pentazocine in an anesthetic combination in maxillo-facial surgery. Ann Anesthesiol Fr 13: 173, 1972.

    Google Scholar 

  18. Hatano S, Kean D, Wade MA et al. Diazepam-pentazocine anesthesia for cardiovascular surgery. Canad Anaesth Soc J 21: 586, 1974.

    Article  PubMed  CAS  Google Scholar 

  19. Aldrete JA. 1980. Somnoanalgesia with Pentazepam. In: Trends in Intravenous Anesthesia. (Eds.) Aldrete JA, Stanley TH. Symposia Specialists, Miami, FL p 433.

    Google Scholar 

  20. De Castro J. 1978. les analgésiques centraux et l’anesthesie analgésigue. Elsevier B. Press, S A Bruxelles, Belgium p 97.

    Google Scholar 

  21. Oyama T, Takiguchi M, Sato K. Effects of droperidol-pentazocine-N20 anesthesia on adrenocortical function in man. Canad Anaesth Soc J 18: 298, 1971.

    Article  PubMed  CAS  Google Scholar 

  22. Kothary SP, Zsigmond EK. Plasma Cortisol and norepinephrine after pain relief. Excerp Med ICS 533: 1010, 1980.

    Google Scholar 

  23. Del Pizzo A. Butorphanol, a new intravenous analgesic: Double-blind compison with morphine sulfate in postoperative patients with moderate or severe pain. Curr Ther Res 20: 221, 1976.

    Google Scholar 

  24. Tavakoli M, Corssen G, Caruso FS. Butorphanol and morphine. A double-blind comparison of their parenteral analgesic activity. Anesth Analg 55: 394, 1976.

    Article  PubMed  CAS  Google Scholar 

  25. Dobkin AB, Eamkaow S, Zak S et al. Butorphanol: A double-blind evaluation in postoperative patients with moderate or severe pain. Can Anaesth Soc J 21: 600, 1974.

    Article  PubMed  CAS  Google Scholar 

  26. Lippmann M, Mok MS, Steen SN et al. Butorphanol and morphine: A double-blind multiple intramuscular dose comparative safety and efficacy study in patients with postoperative pain. Curr Ther Res 21: 427, 1977.

    Google Scholar 

  27. Dobkin AB, Eamkaow S, Caruso FS. Butorphanol and pentazocine in patients with severe postoperative pain. Clin Pharmacol Therap 18: 547, 1975.

    CAS  Google Scholar 

  28. Dobkin AB, Africa BF, Noveck RJ et al. Butorphanol tartrate: 1. Safety and efficacy in multidose control of postoperative pain. Can Anaesth Soc J 23: 596, 1976.

    Article  PubMed  CAS  Google Scholar 

  29. Kliman A, Lipson MJ, Warren R et al. Clinical experience with intramuscular butorphanol for the treatment of a variety of chronic pain syndromes. Curr Ther Res 22: 105, 1977.

    Google Scholar 

  30. Lippmann M, Mok MS, Steen SN et al. Analgesic onset time of intravenous butorphanol in postsurgical patients: A placebo-controlled study. Curr Ther Res 22: 276, 1977.

    Google Scholar 

  31. Zeedick JF. Efficacy and safety evaluation of butorphanol in postoperative pain. Curr Ther Res 22: 707, 1977.

    Google Scholar 

  32. Nagashima H, Foldes FF, Karamanian A et al. Respiratory and circulatory effects of intravenous butorphanol and morphine. Clin Pharmacol Therap 19: 738, 1976.

    CAS  Google Scholar 

  33. Schurig JE, Cavanagh RL, Buyniski JP. The effects of butorphanol and morphine on pulmonary mechanics, arterial blood pressure and venous plasma histamine levels in anesthetized dogs. Fed Proc 35: 546, 1976.

    Google Scholar 

  34. Roebel LE, Cavanagh RL, Buyniski JP. Comparative gastrointestinal and biliary tract effects of morphine and butorphanol. J Med 10: 225, 1979.

    PubMed  CAS  Google Scholar 

  35. Dobkin AB, Arandia HY, Byles PH et al. Butorphanol tartrate. 2. Safety and efficacy in balanced anesthesia. Can Anaesth Soc J 23: 601, 1976.

    Article  PubMed  CAS  Google Scholar 

  36. Del Pizzo A. A double-blind study of the effect of butorphanol compared with morphine in balanced anaesthesia. Can Anaesth Soc J 25: 392, 1978.

    Article  PubMed  Google Scholar 

  37. Stehling LC, Zauder HL. Double-blind comparison of butorphanol tartrate and meperidine hydrochloride in balanced anesthesia. J Int Med Res 6: 384, 1978.

    PubMed  CAS  Google Scholar 

  38. Stanley TH, Reddy P, Gilmore S et al. The cardiovascular effects of high dose butorphanol-nitrous oxide anesthesia before and during operation. Can Anaesth Soc J 30: 337, 1983.

    Article  PubMed  CAS  Google Scholar 

  39. Murphy MR, Hug CC. The enflurane sparing effect of morphine, butorphanol, and nalbuphine. Anesthesiology 57: 489, 1982.

    Article  PubMed  CAS  Google Scholar 

  40. De Castro J, Kay B, Reneman A, Van de Water A, Wouters L, Xhonneux R. Comparative study of cardiovascular, neurological and metabolic side effects of eight narcotics in dogs. Acta Anaesth Belg 30: 5, 1979.

    PubMed  Google Scholar 

  41. Popio KA, Jackson DH, Ross AM et al. Hemodynamic and respiratory effects of morphine and butorphanol. Clin Pharmacol Therap 23: 281, 1978.

    CAS  Google Scholar 

  42. Jasinski DR, Persnick JS, Griffith JD, Gorodetzky CW, Cove EJ. Progress report on studies from the Clinical Pharmacology Section of the Addiction Research Center, Problems of Drug Dependence, Proceedings, pp 112, 1976.

    Google Scholar 

  43. Pittmann KA, Smyth RD, Mayol RF. Serum levels of butorphanol by radioimmuno-assay. J Pharm Sci 69: 160, 1980.

    Article  Google Scholar 

  44. Elliot HW, Navarro G, Nomof N. Double-blind controlled study of the pharmacologic effects of nalbuphine (En-2234A). J Med (Basel) 1: 74, 1970.

    Google Scholar 

  45. Forrest WH, Jr. Report of the Veterans Administration Cooperative Analgesic Study: Parenteral Analgesic Bioassay of Endo 2234 A (N-Cyclobutyl-methyl-7-8-dihydro- 14hydroxynormorphine). Probl Drug Depend 239: 81, 1971.

    Google Scholar 

  46. Beaver WT, Feise GA. Comparison of the analgesic effect of intramuscular nalbuphine and morphine in patients with postoperative pain. Clin Pharmacol Therap 19: 103, 1976.

    Google Scholar 

  47. Beaver WT, Feise GA. A comparison of the analgesic effect of intramuscular nalbuphine and morphine in patients with postoperative pain. J Pharmacol Exper Ther 204: 487, 1978.

    CAS  Google Scholar 

  48. Beaver WT, Feise GA. Comparison of the analgesic effect of intramuscular and oral nalbuphine in patients with postoperative pain. Clin Pharmacol Therap 23: 108, 1978.

    Google Scholar 

  49. Bikhazi GB. Comparison of morphine and nalbuphine in postoperative pediatric patients. Anesthesiology Rev 5: 34, 1978.

    Google Scholar 

  50. Okun R. Analgesic effects of oral nalbuphine and codeine in patients with postoperative pain. Clin Pharmacol Therap 32: 517, 1982.

    Article  CAS  Google Scholar 

  51. Stambaugh JE. Evaluation of nalbuphine efficacy and safety in the management of advanced malignancy. Clin Pharmacol Therap 29: 284, 1981.

    Google Scholar 

  52. Romagnoli A, Keats AS. Comparative hemodynamic effects of nalbuphine and morphine in patients with coronary artery disease. Cardiovascular Disease. Bull Texas Heart Inst 5: 19, 1978.

    Google Scholar 

  53. Lee G, Low RI, Amsterdam EA, DeMaria AN, Huber PW, Mason DT. Hemodynamic effects of morphine and nalbuphine in acute myocardial infarction. Clin Pharmacol Therap 29: 625, 1981.

    Article  Google Scholar 

  54. Lake CL, Duckworth EN, DiFazio CA, Durbin CG, Magruder MR. Cardiovascular effects of nalbuphine in patients with coronary or valvular heart disease. Anesthesiology 57: 498, 1982.

    Article  PubMed  CAS  Google Scholar 

  55. Romagnoli A, Keats AS. Ceiling effect for respiratory depression by nalbuphine. Clin Pharmacol Therap 27: 478, 1980.

    Article  CAS  Google Scholar 

  56. Gal TJ, DiFazio CA, Moscicki J. Analgesic and respiratory depressant activity of nalbuphine: a comparison with morphine. Anesthesiology 57: 367, 1982.

    Article  PubMed  CAS  Google Scholar 

  57. Magruder MR, Delaney RD, DiFazio CA. Reversal of narcotic-induced respiratory depression with nalbuphine hydrochloride. Anesthesiol Rev 9: 34, 1982.

    Google Scholar 

  58. Julien RM. Effects of nalbuphine on normal and oxymorphone-depressed ventilatory response to carbon dioxide challenge. Anesthesiology 57: A320, 1982.

    Article  Google Scholar 

  59. DiFazio CA, Moscicki JC, Magruder MR. Anesthetic potency of nalbuphine and interaction with morphine in rats. Anesth Analg 60: 629, 1981.

    Article  PubMed  CAS  Google Scholar 

  60. Bluhm R, Zsigmond, EK, Winnie AP. Potentiation of opioid analgesia by H1- and H2-blockers. Life Sci 31: 1229, 1982.

    Article  PubMed  CAS  Google Scholar 

  61. Jasinski DR, Mansky PA. Evaluation of nalbuphine for abuse potential. Clin Pharamcol Therap 13: 78, 1972.

    CAS  Google Scholar 

  62. Muldoon S, Otto J, Freas W, Watson RL. The effects of morphine, nalbuphine, and butorphanol on adrenergic function in canine saphenous veins. Anesth Analg 62: 21, 1983.

    Article  PubMed  CAS  Google Scholar 

  63. Rosow CE, Miller ML, Poulsen-Burke J, Cochin J. Opiates and thermo-regulation in mice. III. Agonist- antagonists. J Pharmacol Exp Therap 220: 468, 1982.

    CAS  Google Scholar 

  64. Magruder MR, Christofforetti R, DiFazio CA. Balanced anesthesia with nalbuphine hydrochloride. Anesthesiology Rev 7: 25, 1980.

    Google Scholar 

  65. Fahmy NR. Nalbuphine in “balanced” anesthesia: its analgesic efficacy and hemodynamic effects. Anesthesiology 53: S66, 1980.

    Article  Google Scholar 

  66. Camagay IT, Gomez QJ. Balanced anesthesia with nalbuphine hydrochloride in pediatric patients: preliminary study. Philippine J Anesth 6: 10, 1982.

    Google Scholar 

  67. Zsigmond EK . 1984. Hemodynamic effects and pharmacokinetics of diazepam-nalbuphine ataractanalgesia. Nalbuphine as a component of surgical anesthesia. ( Ed.) Gomez QJ, New York Excerp Med ISSN.

    Google Scholar 

  68. Kumar Sm, Kothary SP, Zsigmond EK. Plasma free-norepinephrine and epinephrine concentrations following diazepam-ketamine induction in patients undergoing cardiac surgery. Acta Anaesth Scand 22: 593, 1978.

    Article  PubMed  CAS  Google Scholar 

  69. Zsigmond EK, Tran L, Barabas E, Wang XY. Hemodynamic and endocrine effects of reversal of fentanyl-induced respiratory depression by nalbuphine. Anesthesiology 61:, 1984.

    Google Scholar 

  70. Man-Wai Lo, Juergens GP, Whitney CC. Determination of nalbuphine in human plasma by automated high-performance liquid chromatography with electrochemical detection. Res Com Chem Pathol Pharmacol 43: 159, 1984.

    CAS  Google Scholar 

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© 1985 Martinus Nijhoff Publishers, Dordrecht

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Zsigmond, E.K. (1985). New Uses for Agonist-Antagonists in Anesthesia. In: Stanley, T.H., Petty, W.C. (eds) Anesthesiology: Today and Tomorrow. Developments in Critical Care Medicine and Anaesthesiology, vol 9. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-5000-9_11

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  • DOI: https://doi.org/10.1007/978-94-009-5000-9_11

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-8714-8

  • Online ISBN: 978-94-009-5000-9

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