Neuroleptanesthesia: current status
Bissonnette B, Swan H, Ravussin P, Un V.
Department of Anaesthesia,
Hospital for Sick Children,
Toronto, Ontario, Canada.
Can J Anaesth. 1999 Feb;46(2):154-68


PURPOSE: To review the current status and possible future of neuroleptanalgesia/anesthesia, techniques that may be nearly extinct. SOURCE: Articles from 1966 to present were obtained from the Current Science and Medline databases. Search terms include neurolepananalgesia/anesthesia, conscious sedation, droperidol, benzodiazepines, propofol, ketamine, and opioids. Information and abstracts obtained from meetings on this topic helped complete the collection of information. PRINCIPAL FINDINGS: Droperidol/fentanyl may still be clinically indicated in the management of surgical seizure therapy for electrocorticography. However, the high incidence of post-operative sedation and restlessness discourage its use for other surgical or diagnostic procedures. Many surgical interventions, once thought ideally suited for neuroleptic agents, now meet better success with newer medications. The use of midazolam and/or propofol, in association with newer opioids, provides ideal anesthetic combinations. CONCLUSION: The advantages of newer anesthetic agents have redefined the clinical indications for neuroleptanesthesia. In routine modern anesthesia, anxiolysis, sedation, and/or analgesia is better provided, with quicker recovery, by the new pharmacokinetic and pharmacodynamic characteristics of recent medications than by the neuroleptic component of neuroleptanesthesia.
Nitrous oxide
Inhaled anaesthetics
Obstetric anaesthesia
Molecular mechanisms
Chloroform anaesthesia
A thalamocortical switch?
Anaesthesia and the spinal chord
History of anaesthesia apparatus
Consciousness, anaesthesia and anaesthetics
Anaesthesia: mutants in yeast, nematodes, fruit flies and mice

and further reading
Future Opioids
BLTC Research
Utopian Surgery?
The Good Drug Guide
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World