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Canadian Journal of Anesthesia, Vol 13, 272-281, Copyright © 1966 by Canadian Anesthesiologists' Society

A Report on Clinical uses of Droperidol and Fentanyl

J. H. MORAN M.D., D.A.(TOR.), F.R.C.P.(C)1 and B. M. MARSHALL M.D., F.R.C.P.(C)1

1 Department of Anaesthesia, University of Toronto, the Toronto General Hospital, and the Princess Margaret Hospital

The drugs introduced from Europe to produce neuroleptanalgesia have been investigated, separately and together, in an attempt to determine whether they have sufficient merit to make them necessary to, or desirable in, the anaesthetist's armamentarium. Our study varies from most others which have been reported in that all our patients were breathing spontaneously, and in that the neuroleptic and analgesic drugs were given separately rather than in a fixed combination.

We have found the drugs both separately and in combination to have certain benefits and certain disadvantages, as outlined above. Our conclusions based onthis clinical appraisal are:

1. Induction and maintenance of neuroleptanalgesia plus light general anaesthesia is moderately complicated.

2. Intramuscular administration of droperidol gives less consistent results than intravenous administration.

3. Respiratory depression is frequent, but is easy to control.

4. Cardiovascular function is extremely stable with this form of anaesthesia.

5. Bronchospasm and/or muscular rigidity may occur during the course of anaesthesia.

6. The postoperative course is notable for its apparent lack of pain and the prolonged tranquility of the patient.

7. Droperidol alone has marked anti-emetic properties, but slight hypnotic properties.

8. Neuroleptanalgesia as a supplement to nitrous oxide is not sufficient to provide adequate anaesthetic coverage for surgical procedures in some patients without the addition of further narcosis or of another anaesthetic agent.

The technique of neuroleptanalgesia (without added general anaesthetic) or neuroleptanaesthesia (with added general anaesthetic) should be considered in the following situations.

1. Investigative or surgical procedures where patient co-operation is necessary.

2. Procedures where cardiovascular stability may be jeopardized due to movement or position of patient.

3. Procedures where patient disease or anaesthetic toxicity contraindicates conventional anaesthetic techniques.

4. Procedures in which postoperative tranquility without depression of the cardiovascular system and with or without depression of the respiratory system is desired.

5. Procedures in which immediate postoperative alertness is desired.

Note:

Dehydrobenzpiridol R 4749 and Phentanyl R 4263, supplied by McNeil Laboratories of Canada Ltd.






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Copyright © 1966 by the Canadian Anesthesiologists' Society.