Abstract

This is a “dirty” clinical study but one that does have some interesting observations. It is dirty because one cannot determine whether equal analgesic depth was used in both groups. It is also exceedingly difficult to define end points in this type of study. Unfortunately, the author chose a procedure that frequently does not require narcotic or ketamine but, instead, the use of nitrous oxide and oxygen along with hyper-ventilation represents sufficient analgesia. Continuous infusion of analgesics, especially those that are short-acting, certainly makes pharmacologic sense. One would expect an attenuation of the changes in cardiovascular and respiratory variables, and the author certainly did. Even more promising is the thought that perhaps we will soon have readily available the narcotic alfentanil, which is even shorter acting and, therefore, lends itself much more readily to continuous infusion.

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