Neuroleptanalgesia

The Neuroleptanalgesia is since its introduction by J. De Casto and P. mouth empty in Belgium practiced 1,959 special form of analgesia , in which a highly potent neuroleptic (z. B. droperidol , in veterinary medicine, especially acepromazine ) in combination with a potent painkillers ( usually fentanyl , in veterinary medicine levomethadone ) creates an anesthetic-like condition. In contrast to anesthesia , however, the patient is not deeply unconscious , but is only heavily sedated with significantly reduced pain sensation. The advantage of this combination is the mutual reinforcement of the analgesic and sedative effect while weakening the nausea and vagus-stimulating effect of the pain reliever. The main disadvantage is the sharp drop in blood pressure.

History

In the 1940s, two scientists invented the lytic cocktail. This cocktail consisted of: chlorpromazine , promethazine and pethidine . They called the effects of this cocktail neuroplegia.

Indications

Neuroleptanalgesia can be used for interventions that do not require deep unconsciousness.

Contraindications

Neuroleptanalgesia is contraindicated for the following factors:

Neuroleptic anesthesia

In larger operations, however, neuroleptanalgesia could not achieve sufficient hypnosis , so laughing gas was added as an additional hypnotic.

Neuroleptanalgesia is rarely used in human medicine today; it was modified from 1968. As soon as the neuroleptanalgesia is supplemented with nitrous oxide , one speaks of neuroleptanesthesia. With the combination of nitrous oxide and droperidol, sufficient loss of consciousness is achieved in most cases. Even so, this type of anesthesia was often too weak, which is why some patients woke up intraoperatively. Which is why it is only used in special cases (see indications).

literature

Wolfgang Löscher et al .: Pharmacotherapy in pets and farm animals. Parey, 7th ed. 2006, ISBN 978-3-8304-4160-1 , pp. 87-88.
Christoph Weißer: Anesthesia. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte . De Gruyter, Berlin 2005, ISBN 3-11-015714-4 , p. 54 f., Here: p. 54.

Individual evidence

↑ Michael Heck, Michael Fresenius: Repetitorium Anaesthesiologie. Preparation for the anesthesiological specialist examination and the European diploma in anesthesiology. 3rd, completely revised edition. Springer, Berlin / Heidelberg / New York et al. 2001, ISBN 3-540-67331-8 , p. 804. - Online .
↑ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l DocCheck Medical Services GmbH: Neuroleptanalgesia. Retrieved April 13, 2020 .
↑ Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 35.

[1] Michael Heck, Michael Fresenius: Repetitorium Anaesthesiologie. Preparation for the anesthesiological specialist examination and the European diploma in anesthesiology. 3rd, completely revised edition. Springer, Berlin / Heidelberg / New York et al. 2001, ISBN 3-540-67331-8 , p. 804. - Online .

[:0-2] ↑ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l DocCheck Medical Services GmbH: Neuroleptanalgesia. Retrieved April 13, 2020 .

[3] Reinhard Larsen: Anesthesia and intensive medicine in cardiac, thoracic and vascular surgery. (1st edition 1986) 5th edition. Springer, Berlin / Heidelberg / New York et al. 1999, ISBN 3-540-65024-5 , p. 35.