title: [Methohexital/alfentanil-thiopental/alfentanil for total intravenous anesthesia for direct laryngoscopy with 100% O2 jet ventilation].
abstract: For the direct laryngoscopy and microscopic examination of the larynx with exploratory excision and pulpectomy using low frequency jet-ventilation with 100% oxygen we used total intravenous anaesthesia with a strong acting opioid and a barbiturate. Because the achievement of sufficient reflexes and a high degree of vigilance postoperatively are to be aimed, Methohexitone (M) and Thiopentone (T) were investigated in the regard of the suppression of vigilance in the postoperative period. 40 patients were randomly assigned to the group M (n = 20) or T (n = 20). The evening before operation, an intelligence test and a syndrome-short-test (SST) were performed for the measurement of attention and memory (functional psychosis). The patients received 2 mg Flunitrazepam orally and transdermal Scopolamine. On the day of operation the patients received 1 mg Lormetazepam orally for premedication. Anaesthesia was induced with 2 mg Alcuronium, 1 mg Alfentanil, 1.4 mg/kg bodyweight M respectively 5 mg/kg bodyweight T and 1.4 mg/kg bodyweight Succinylcholine. Immediately before laryngoscopy the patients received 2-4 mg Alfentanil. Muscle relaxation was achieved by an infusion with Succinylcholine using relaxometry. Methohexitone respectively Thiopentone were administered by infusion depending on clinical signs indicating insufficient anaesthesia. The following parameters were measured: Blood pressure, heart rate, duration of operation and anaesthesia, parameters of vigilance 30, 60 and 120 minutes after operation (SST) and the ability of performance. The groups were comparable with respect to all data except the parameters of vigilance. The patients receiving M were significantly more vigilant 30 min., 60 min. (SST) and 120 min (SST) after the end of anaesthesia than patients receiving T (p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015760:Alfentanil; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D001143:Arousal / Q000187:drug effects; D002986:Clinical Trials as Topic; D005260:Female; D005283:Fentanyl / Q000031:analogs & derivatives*; D006611:High-Frequency Jet Ventilation; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery; D007828:Laryngoscopy; D008297:Male; D008723:Methohexital; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011446:Prospective Studies; D011897:Random Allocation; D013874:Thiopental
chemical_list: D015760:Alfentanil; D008723:Methohexital; D013874:Thiopental; D005283:Fentanyl
vernacular_title: Methohexital/Alfentanil-Thiopental/Alfentanil zur totalen intravenösen Anästhesie für die direkte Laryngoskopie unter 100% O2-Injektorbeatmung.