Synergistic basal narcosedation. A basic technique employing promethazine, meperidine, and secobarbital.

Abstract

An elastic, universally applicable technique for narcosedation is the culmination of a new philosophy for the anesthetic management of the ambulatory dental patient and is particularly advantageous for those who have physical or psychological problems. The method employs promethazine and meperidine, supported with secobarbital, by intravenous injection and thus provides synergistic basal narcosedation with extraordinarily small doses of meperidine, the barbiturate, and the indicated anesthetic agent. The method permits performance of operations of ninety minutes or more under local anestheties in small amounts, or induction of any stage of general anesthesia from analgesia to the surgical planes required for more extensive oral procedures, without the excitement characteristic of inhalation anesthesia produced by conventional methods. Following a clinical trial of various methods for preanesthetic medication in 252 patients, seventy-one patients successfully underwent dental procedures after they had received intravenous basal narcosedation with the three agents described. Advantages are maximum safety; desirable antihistaminie and antiemetic action; prolonged anesthesia produced with smaller-than-usual dosage of the anesthetic agent and readily maintained with high levels of oxygenation; rapid initial recovery time; and minimum effect on vital functions.