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The Role of Thiopental and Fentanyl in the Production of Balanced Anaesthesia
Author(s) -
Tammesto T.,
Aromaa U.,
Korttila K.
Publication year - 1980
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1980.tb01500.x
Subject(s) - fentanyl , anesthesia , medicine , thiopental sodium , propofol , nociception , receptor
In order to clarify the interactions between various doses of thiopental and fentanyl in producing “balanced anaesthesia”, their effects on consciousness, superficial nociception, and respiration and circulation were studied during N 2 O f O 2 inhalation in connection with the induction of anaesthesia. Altogether 60 patients were studied; the drug combinations used were thiopental 5 mg/kg (TPs), thiopental 3 mg/kg (TP,), thiopental 3 mg/kg and fentany1 0.5 μg/kg (TP 3 Fo 5 ), thiopental 2 mg/kg and fentanyl I pg/kg (TPPFI), thiopental 1 mg/kg and fentanyl 2 μg/kg (TP 1 F 2 ), and fentanyl 3 μg/kg (F3). Five minutes after the i.v. supplementation of N 2 O+ O 2 anaesthesia, the depth of anaesthesia and analgesia (antinociception) were evaluated from the eyelid reflex and by pinching an inguinal skin fold. Cardiorespiratory parameters were measured during this study period at 1 ‐min intervals. The balance between antinociception and anaesthesia was closest to optimum in groups TP 2 F 1 and TP 3 Fo 5 . In pure thiopental groups, the analgesia was poor; only four patients did not respond to the nociceptive stimulus, whereas in group F 3 anaesthesia (disappearance of the eyelid reflex) was obtained in only two patients. The respiratory depression was most pronounced in groups receiving 3 ,2 and 1 μg/kg fentanyl and weakest in groups where only thiopental was used. Blood pressure decreased in all groups but no statistically signscant diKerences were noted. On the basis of the results it seems obvious that attempts to achieve what is called “balanced anaesthesia” by the supplementation of an N 2 O + O 2 mixture with fentanyl only leads to an unnecessarily pronounced respiratory depression, whereas supplementation with thiopental alone does not offer adequate antinociception.