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The Role of Diazepam and Fentanyl in the Production of Balanced Anaesthesia
Author(s) -
Aromaa U.,
Korttila K.,
Tammisto T.
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.tb01501.x
Subject(s) - diazepam , fentanyl , medicine , anesthesia , reflex , general anaesthesia
The effects of diazepam‐fentanyl combinations on consciousness, superficial nociception, respiration and circulation during N 2 O + O 2 inhalation were studied in 40 premedicated patients during induction of anaesthesia. The balance between antinociception and anaesthesia was closest to the optimum in patients receiving 0.2 mg/kg of diazepam plus 1 μg/kg of fentanyl; the eyelid reflex was negative in all patients and only two out of ten patients reacted to abdominal pinching. When only 0.2 mg/kg of diazepam was given with N 2 O + O 2 , the eyelid reflex was negative in all patients, but half of them reacted to pinching. When the dose of diazepam was reduced to 0.1 mg/kg and patients received 1 or 2 μg/kg of fentanyl, the balance between anaesthesia and antinociception was good, but 30–50% of patients had a positive eyelid reflex and reacted to pinching. No distinct respiratory depression was observed in patients given 0.2 mg/kg of diazepam, whereas seven patients given 0.1 mg/kg of diazepam plus 2 μg/kg of fentanyl had apnoea lasting more than 60 s associated with a significant (P<0.05–0.001) increase in end‐tidal CO 2 and PCO 2 in arterialised venous blood. No significant changes were observed in blood pressure or heart rate after any of the drugcombinations studied. It appears that an optimal balance between anaesthesia and antinociception with minimal side‐effects during balanced general anaesthesia requires reinforcement of N 2 O+O 2 anaesthesia not only with fentanyl but also with hypnotics or sedatives.