Abstract OPERATIONS for otosclerosis have been generally performed using a combination of heavy premedication and local anaesthesia. When fenestrations were in vogue, general anaesthesia was usually employed. With the advent of stapedectomy, otologists preferred to have a rousable, awake, and cooperative patient.1 This enabled the surgeon to (1) assess the success of the operation, and (2) to serve as a warning for encroachment upon the facial nerve and the labyrinth. In addition, the patient was relatively free from nausea and vomiting, spared the effects of potent general anesthetic agents. and was able to drink and eat early in the postoperative period. Early discharge of the patient from the hospital was facilitated. The typical preoperative drugs consisted of a barbiturate (pentobarbital 100 to 200 mg 90 minutes preoperatively), a narcotic (meperidine 75 mg), and a phenothiazine tranquilizer (promethazine 50 mg).2 The latter drugs were given 1 hour preoperatively. This provided References 1. Stubensey, L.A.: Discussion of Anaesthetic Procedures for Fenestration Operation , Anesthesiology 14:303-310 ( (May) ) 1953.Crossref 2. Miller, G.L., and Shea, J.J.: Narcosis for Otologic Surgery , Arch Otolaryng 78:155-159 ( (Aug) ) 1963.Crossref 3. Milowsky, J., and Scheer, A.A.: Anaesthesia for Stapes Surgery , Arch Otolaryng 80:43-47 ( (July) ) 1964.Crossref 4. Decastro, J., and Mundeleer, P.: Anaesthesia sans barbiturique: la neuroleptanalgesia , Anaesth Analg (Paris) 16:1022-1056, 1959. 5. Corssen, G.; Domino, E.F.; and Sweet, R.B.: Neuroleptanalgesia and Anaesthesia: Pharmacologic and Clinical Considerations , Anesth Analg (Cleveland) 43:744 ( (Nov) -Dec) 1964. 6. Nilsson, E.: Experience With Neuroleptanalgesia , Anaesthetist 11:17, 1962. 7. Tait, E.C., and Tornetta, F.J.: Neuroleptanalgesia: As Adjunct to Local Anaesthesia in Intraocular Surgery: A Preliminary Report , Amer J Ophthal 59:412 ( (March) ) 1965. 8. Wine, N.A.: Sedation With Neuroleptanalgesia in Cataract Surgery , Amer J Ophthal 61:456 ( (March) ) 1966. 9. Jones, W.M., et al: Neuroleptanalgesia for Intraocular Surgery , Canad Anaesth Soc J , vol 15, (Sept) -Oct, 1968. 10. Jones, W.M., et al: Anaesthesia for Intraocular Surgery, Canad J Ophthal, to be published. 11. Dowdy, E.G., et al: A New Treatment of Meniere's Disease , Arch Otolaryng 82:494-497 ( (Nov) ) 1965.Crossref 12. Krantz, J.C., and Carr, C.J.: Pharmacologic Principles of Medical Practice , Baltimore: Williams & Wilkins, Co., 1965.
Archives of Otolaryngology – American Medical Association
Published: Nov 1, 1968
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