Neuroleptanalgesia with fentanyl-droperidol: an appreciation based on more than 1000 anaesthetics for major surgery.

NEffBOLEPTANAL6ESIA (NLA) has been practiced in Europe since 1959, and today the largest personal series exceed 10,000 cases, z The anaesthetic aims at providing psychomotor sedation while leaving cortical and homeostatic hmctions as intact as possible. ~ At the present time this selective action is achieved by the use of two agents, droperidol and fentanyl. These are given intravenously and may be administered either independent of each other or as a standard mixture, usually supplementing nitrous-oxide anaesthesia. First reports were cautiously received on this side d the Atlantic; 8 American anaesthetists are as reluctant to employ anaesthetic "cocktails" as these are dear to the hearts of their European colleagues. It was shown subsequently, however, that NLA compares well with conventional anaesthetics in most situations and that it is decidedly superior to them in geriatric surgery, 4 open-heart procedures, s patient acceptance, s and certain special surgical situations. 7 In view of this mounting evidence a r~sum~ of our technique and a review of the indications and contraindications for NLA, as seen after more than three years' experience with the drug, appear timely.