Der Anaesthesist
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Biography Historical Article
[On the 200th birthday of Friedrich Wilhelm Adam Sertürner].
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The haemodynamic and respiratory-depressive effects of 20 micrograms/kg and 40 micrograms/kg of alfentanil in 54 patients with coronary bypass operation were compared with a control group (n = 36). The measurements were carried out at 3 different times, each lasting over a 10 min period: 1. Before induction of anaesthesia but after premedication with flunitrazepam. 2. ⋯ In the intraoperative period this did not occur. The respiratory depression(paO2: -34%, paCO2: +29%) resembles that after fentanyl, except that it starts earlier and lasts for a shorter time. In summary, it can be stated that all effects after alfentanil are similar to those of fentanyl.
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Oral morphine sulphate is the strong narcotic of choice at most hospices. Administered in simple aqueous solution (e.g. 10 mg in 10 ml). No advantage in giving as "Brompton Cocktail." Usual starting dose 10 mg every 4 h. ⋯ Write out regimen in detail with times to be taken, names of drugs and amounts to be taken. Warn patient of possibility of initial drowsiness. Arrange for close liaison and follow up.