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November 1968

Neuroleptanalgesia for Stapes Surgery

Author Affiliations

From the departments of anaesthesia (Drs. Jones and Boyes) and otolaryngology (Drs. Fee and Bell), Toronto Western Hospital and University of Toronto.

Arch Otolaryngol. 1968;88(5):491-494. doi:10.1001/archotol.1968.00770010493007

OPERATIONS for otosclerosis have been generally performed using a combination of heavy premedication and local anaesthesia.

When fenestrations were in vogue, general anaesthesia was usually employed. With the advent of stapedectomy, otologists preferred to have a rousable, awake, and cooperative patient.1 This enabled the surgeon to (1) assess the success of the operation, and (2) to serve as a warning for encroachment upon the facial nerve and the labyrinth. In addition, the patient was relatively free from nausea and vomiting, spared the effects of potent general anesthetic agents. and was able to drink and eat early in the postoperative period. Early discharge of the patient from the hospital was facilitated.

The typical preoperative drugs consisted of a barbiturate (pentobarbital 100 to 200 mg 90 minutes preoperatively), a narcotic (meperidine 75 mg), and a phenothiazine tranquilizer (promethazine 50 mg).2 The latter drugs were given 1 hour preoperatively. This provided