Alphaprodine (nisentil) hydrochloride in anesthesia; its use, with or without antagonists, for supplementation or as sole agent.

Abstract

• Alphaprodine (Nisentil) was used as the narcotic analgesic in 209 patients undergoing a variety of major and minor surgical operations. It was given intravenously in amounts ranging from single doses of 30 mg. to multiple doses totaling 1,620 mg. These doses generally exceeded by for what would ordinarily be considered safe; their use was made possible by the simultaneous administration of levallorphan (148 cases) or nalorphine (49 cases), which prevented respiratory depression but did not interfere with the pain-relieving effect. The analgesia so attained was satisfactory, and supplementation with other anesthetics, whether local or general, was in many cases unnecessary. Alphaprodine was thus found to have a high analgesic potency that becomes especially manifest if levallorphan is used at the same time to offset the respiratory depression caused by it. The combination should be used more widely either as the sole anesthetic agent or to supplement others.