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Neuroleptanalgesia for Awake Pronation of Surgical Patients

CHINGMUH LEE, MD^*, ANGELINE BARNES, MD, and EUGENE L. NAGEL, MD

*Assistant Professor. Fellow. Professor and Chairman. Department of Anesthesiology, UCLA School of Medicine, Harbor General Hospital Campus, Torrance, California 90509.

Abstract

Pronation of anesthetized patients may result in complications. Neuromuscular block increases the risk. To minimize the risk, the authors devised a technic of "awake pronation," evaluating its feasibility, in 11 consecutive patients in a 1-year period for 12 operations; all attempts were successful and without complications. Neuroleptanalgesia is achieved with droperidol and fentanyl, topical anesthesia of the upper airway is induced with lidocaine, awake intubation is performed orotracheally under direct vision, and pronation is accomplished with patient cooperation.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999