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Innovar in surgical anaesthesia

1965; Springer Nature; Volume: 12; Issue: 6 Linguagem: Inglês

10.1007/bf03004423

0008-2856

W. E. Spoerel, Wing Shing Chan,

Anesthesia and Pain Management

Innovar, a mixture of phentanyl and droperidol (0.CI2 mg./c.c. and 1 mg./c.c. respectively), was used to supplement nitrous oxide and other forms of anaesthesia. In contrast to the techniques of neuroleptanalgesia, small doses of thiopen-tone were used for induction and as a hypnotic when required. With this technique, the dosage of Innovar could be reduced, minimizing side-effects.Innovar was given to 230 patients. In 24 it was used to provide sedation during regional anaesthesia; nine bronchoscopies were done using a combination of thiopentone, Innovar, and topical anaesthesia, with superior results.The remaining 197 patients received Innovar to supplement nitrous-oxide anaesthesia. The dosages required were similar in curarized patients on controlled ventilation and patients breathing spontaneously. Innovar: induced a marked slowing of the respiration, although most patients were able to maintain their alveolar ventilation by a corresponding increase in tidal volume; only a mild respiratory acidosis (averagepCO2, 49 mm. Hg) was found in 10 patients after an average of 165 minutes of anaesthesia.Although the technique described lacked the flexibility of inhalation anaesthesia, certain advantages deserve further consideration. Among them, the possibility to intubate the patient without loss of reflexes and without relaxants, the lack of circulatory depression, the; possible benefit of a mild adrenergic blockade, the rapid return of responsiveness, and the calm postoperative period with reduced drug requirements were particularly noticed. At the same time, the postoperative “neurolepsis” may require a closer supervision of the patient.None of the three postoperative deaths in this series can be related to Innovar; however, one circulatory collapse occurred within the possible duration of action of droperidol.Although the term “neuroleptanalgesia” describes the uniqlue effect of this combination of drugs, the justification to apply the term to a technique of general anaesthesia is questioned. The use of Innovar within the framework of the present concept of anaesthesia has shown promising results and shjould be actively continued.