Abstract
Intravenous anesthesia has several advantages for otolaryngological operations. This method does not interfere with the surgeon and expensive equipment like gas machine is scarcely needed. Moreover, the anesthetics can be easily administered and no tracheal stimulation occurs during anesthesia.
Recently, 4-Hydroxybutyrate (4-HB) was synthesized by H. LABORIT and associates. The drug, when given intravenously, produces a non-rousable state of unconsciousness without danger.
4-HB was applied in 115 cases of otolaryngological operations and endoscopic procedures. All the cases were received pethidine with atropine as part of premedication and in about two third of them, nitrazepam was added. 4-HB in a 20% aquaous solution was administered with a dose ranging from 35 to 100 mg per kg of body weight by a single shot or drip infusion. In all the cases, topical anesthesia was adequately performed, when the patients became a state of unconsciousness. During induction or operation, most cases were given small supplemental doses of thiamyral reducing troublesome movement.
There was a rough correlation between dose and duration of effect of 4-HB. With a dose of 80mg per kg of body weight, the patient could be expected to be non-rousable for two to four hours. Moreover, the longer duration could be expected in middle ear operation than sinusectomy, even if the same dose of the drug was administered. The administration of nitrazepam was effective in reducing the remarkable side effects. 4-HB has been safely handled and very useful to facilitate otolaryngological operation and endoscopic procedure.
