By Carter M. Ballinger M.D. (auth.), Theodore H. Stanley M.D., W. Clayton Petty M.D. (eds.)

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Extra resources for Anesthesiology: Today and Tomorrow: Annual Utah Postgraduate Course in Anesthesiology 1985

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Anesthesia techniques - Inhalation anesthesia (ether) IV anesthesia : thiopentone, curare, N20 (classic) lytic cocktail anesthesia (Laborit) - Locoregional anesthesia : local peripheral blocks epidural intrathecal - % 15 65 10 5 3 1 1 Meanwhile, during the same period, Doctor Paul Janssen's belgian laboratories had just synthet1sed new potent narcotics and new neuroleptics which permitted us to develop a more simple technique putting the emphasis on deeper analgesia(3). NLA was first introduced in Lyon, in 1959, at the Congress of the French Society of anesthesiology by Mundeleer and myself The new selective IV anesthesia technique, was clearly different from the classical IV anesthesia and from the lytic cocktail anesthesia.

The per-operative advantages of pure analgesic anesthesia with fentanyl or alfentanil are high : rapid stress free induction, high stress protection, good tolerance and cardiovascular stability. Myocardial contractility remains unimpaired, even in old and poor risk patients with poor ventricular function undergoing major surgery. However, after our early enthusiasm, some inadequacies of the technique became apparent. Cardio- vascular and sympathetic hyperactivity still occured, mostly in young and fit patients.

Is not always fulfilled. b) General anesthesia by itself is,in daily practice, limited to either inhalation anesthesia or NLA performed with small or medium doses of a narcotic. 35). During the per-operative period, inhalation anesthesia, and NLA with small or medium doses of narcotics,provide, insufficient stress protection. c) Stress and pain after surgery continue to evade reliable 59 clinical management. Stress protection by narcotics is only transient; no effect was demonstrated in the post-operative period and nitrogen inbalance cannot be improved during the first post-operative days (36,371.

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