Introduction:
Neuroleptanalgesia is a combination of two drugs to control pain to proceed with further procedures. It is used in animals and humans too. It sedates the patient and forms better reliable results than analgesia drugs. This topic explains neuroleptanalgesia drugs, their usage, advantages, side effects, and the difference between neuroleptanesthesia and neuroleptanalgesia.
What Is Neuroleptanalgesia?
Neuroleptanalgesia is a mixture of two sedative medications, one of which is an opioid and the other a neuroleptic substance. Neuroleptanalgesia is established when potent opioid and neuroleptic or tranquilizer drugs like Droperidol are delivered to the patient. It is a state of central nervous system depression and analgesia. It consists of profound sedation, immobilization, and intense analgesia without loss of consciousness.
Advantages of Using Neuroleptanalgesia
Advantages of using neuroleptanalgesia :
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It has more profound and reliable sedation.
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It causes more reliable results of analgesia (the inability to feel pain).
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It causes fewer effects on respiratory depression.
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Neuroleptic usage of components abolishes the emetic effect and causes slow heart rate or irregular heart rate produced by opioid analgesia.
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It can create a stage of immobilization.
What Are the Indications of Neuroleptanalgesia?
Indications of neuroleptanalgesia are:
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It is used in a few minor surgeries.
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It is used in diagnostic procedures.
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It is delivered as an adjunct to local anesthetic.
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It is used in premedication.
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It is used as chemical restraint of wild and ferocious animals.
What Are the Neuroleptanalgesics Or Drugs Used in Neuroleptanlagesia?
Neuroleptanalgesics are:
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Fentanyl: It is a potent opioid analgesic. It acts on opioid receptors and produces an analgesic effect.
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Droperidol: It is a neuroleptic sedative. It increases the analgesic effect of Fentanyl. It is a potent D2 receptor antagonist with histamine and 5 HT antagonist activity.
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Etorphine: It is an opioid agonist. It is used to immobilize giant domestic and wild animals like elephants.
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Acepromazine: It is a phenothiazine tranquiliser. It is a potent dopamine receptor antagonist with some histamine, serotonin, muscarinic, and adrenergic receptor-blocking actions.
What Are the Effects of the Combinations of the Medicines Used in Neuroleptanalgesia?
The effects of neuroleptanalgesia are:
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Fentanyl And Droperidol - Droperidol causes central antiemetic action, reduces muscle tone, tranquillization, and sedation, and Fentanyl works on opioid receptors and produces analgesia. Its combined effects in dogs have decreased heart rate, increased vagal tone, and reduced arterial blood pressure. In cats, its combination causes an increased heart rate with decreased blood pressure. It has an onset of action of 30 to 40 minutes. The medicine sedates the animals for hours. However, it can also cause wood chest syndrome in dogs and humans after rapid intravenous injections. Its overdosages can occur. It is only recommended in dogs, not in cats, horses, or rabbits.
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Etorphine And Acepromazine - Etorphine is an opioid agonist used in wild animals, whereas Acepromazine blocks the actions of adrenergic receptors. It is used in domestic and wild animals. Domestic animals like horses, cattle, sheep, and pigs can be given Etorphine and Acepromazine combinations of neuroleptanalgesia. It is very toxic for humans and should be delivered only with gloves. Its combination can cause increased heart rate (tachycardia), transient increase in blood pressure (hypertension), muscle tone, and mydriasis (dilated pupil of eye). Etorphine and Acepromazine should not be used unless the antidote Naloxone (opioid antagonist) is available.
Side Effects of Neuroleptanalgesia
Side effects are:
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Slow heart rate.
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More saliva.
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Irritation.
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Respiratory depression.
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Pain.
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Central nervous system depression.
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Ataxia (disorder affecting coordination, balance, and speech).
When Should Neuroleptanalgesia Not Be Used?
One can not use neuroleptanalgesia in:
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Perivascular injection.
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Not used in neonates.
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It is not applicable in cesarean sections.
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It is not used in food for animals.
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Not recommended for all animals.
What Is the Dose of Neuroleptanalgesia Used?
The dose of neuroleptanalgesias are the 0.4 mg Fentanyl and 20 mg Droperidol in each millileliters. The dosage differs in different modes, like 0.1 to 0.15 ml per kg into the muscle (intramuscularly) and 0.04 to 0.08 ml per kg into the veins (intravenously).
Etorphine and Acepromazine are supplied at 2.45 mg per ml. Etorphine with Acepromazine 10 mg per ml in Immobilon and 3 mg per ml Diprenorphine in Revivon.
How Is Neuroleptanalgesia Delivered?
Injections deliver Neuroleptanalgesias. The methods are directly inserting the syringe needles into the muscles (intramuscularly) or inserting the syringe needles into the veins (intravenously).
Is Neuroleptanalgesia Used in Animals Too?
Yes, neuroleptanalgesia has a significant role in veterinary medicine. First, the animals used in the laboratory for testing the drugs or trials on them, like rabbits and guinea pigs, are given neuroleptanalgesia to prolong the effects of anesthesia on them during the laboratory trials. Neuroleptanalgesia is now delivered to the dogs, cats, or horses for another process to work on them. However, many side effects are also seen in animals, like respiratory depression or central nervous system depression.
What Is Neuroleptanesthesia?
Neuroleptanesthesia is a general anesthetic method that combines the intravenous infusion of neuroleptic medications with the inhalation of a mild anesthetic that may or may not include neuromuscular relaxants. It is a concurrent administration of 65 to 70 percent nitrous oxide to neuroleptanalgesic to produce a state of amnesia (inability to remember or memory loss). The patient is completely unconscious and unaware of the environment. The patient cannot obey the commands and communicates with the staff and cannot even move his legs.
What Is the Difference Between Neuroleptanalgesia and Neuroleptanesthesia?
Neuroleptanalgesia is an absence of pain with the patient aware of the surroundings but completely relaxed, where his anxiety is relieved. Compared to neuroleptanesthesia, there is a complete loss of consciousness, and the patient is unaware of the surroundings and does not respond to the commands. However, both states cause the absence of pain and relieve anxiety with relaxation.
Conclusion
Neuroleptanalgesia is the loss of pain caused by neuroleptic medicines. It is used in animals to proceed with other processes in them. There are many other indications present in neuroleptanalgesia. Commonly used neuroleptic medications are Etorphine and Acepromazine combination and Fentanyl and Droperidol combination. The side effects and advantages of neuroleptanalgesia are mentioned in the topic above.
