Neuroleptanalgesia in upper alimentary endoscopy.

Abstract

pethidine. Droperidol (Droleptan) is a major tranquilliser and produces the neuroleptic state of dissociation from the surroundings, in which apprehension is abolished yet normal faculties are retained. It acts rapidly and its peak effect lasts half to two hours. It is also an alpha-adrenergic blocker and a suppressor of the vomiting centre. Fentanyl (Sublimaze) is a narcotic analgesic which in excessive doses will produce respiratory depression. Its actiort is of rapid onset and analgesia lasts 20 to 30 minutes.Droperidol and fentanyl were found to give good analgesia for endoscopy but consciousness isretained.. The effect of these drugs is therefore less easily appreciated by the administrator than that of a drug producing progressive loss of consciousnessMoreover, most patients and most endoscopists would probably regard full awareness, even in a dissociated state, as undesirable.With the object of evolving a technique suitable for use by an endoscopist working without an anaesthetist, it was decided to employ a basal dose of droperidol and fentanyl, not alone sufficient to give full analgesia and well within the tolerance of the patient, followed by slow administration of sufficient diazepam to produce drowsiness. A trial was planned to determine with what regularity this. method would give satisfactory results and whether it could be used with safety without an anaesthetist in the endoscopy room. MethodsThe trial ran for approximately one year from October 1974 to September 1975 and 250 patients were included. As far as possible these were consecutive cases coming for endoscopy, including urgent examinations. Cases were eliminated only 655 on 10 May 2018 by guest. Protected by copyright.

Premedication for Upper Gastrointestinal Endoscopy: A Comparative Study of Flunitrazepam, Diazepam and Neuroleptanalgesia

“…Although upper gastrointestinal endoscopy can be performed without sedation, it is widely accepted that some form of sedation is desirable (1)(2)(3)(4)(5). Narcotic analgesics, barbiturates, benzodiazepines and neuroleptanalgesia have been used but no one regime has received general acceptance (6-9).…”