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In a retrospective study comparing normotensive (twenty-two patients) and controlled hypotensive (forty-four patients) anesthesia for spine fusion and Harrington instrumentation, the use of hypotensive anethesia was found to decrease the need for blood replacement and total blood loss by an average of 40 per cent and to reduce the average operating time by more than thirty minutes. No complications attributable to the anesthetic technique occured.

A general method for the syntheses of no-carrier-added (NCA) 18F-labeled butyrophenone neuroleptics--benperidol, haloperidol, spiroperidol, and pipamperone is described. These 18F-labeled neuroleptic drugs are synthesized by a multistep synthesis in an overall radiochemical yield of 10-20% at end of bombardment (EOB) in a synthesis time of 90 min from EOB. The sequence involves the synthesis of NCA p-[18F]fluorobenzonitrile from NCA [18F]-fluoride and p-nitrobenzonitrile using the rapidly converted to gamma-chloro-p-[18F]fluorobutyrophenone which is alkylated with appropriate amines to give NCA 18F-labeled benperidol, haloperidol, spiroperidol, and pipamperone. The final product is purified by preparative high performance liquid chromatography (HPLC). The 18F solution used in the synthesis as determined by ion chromatography contains 15.3 +/- 9.0 nmol of stable fluoride. The specific activities of the resulting butyrophenone neuroleptics were determined to be 3 Ci/mumol (at EOB) (range 1-6 Ci/mumol) as determined by radioreceptor assay and HPLC assay.

In 17 patients, the reversal by naloxone of a short duration narcotic anesthesia done for neuroradiology, was studied. Neuroleptanalgesic technique comprised d-hydrobenzperidol (5-10 mg) and fentanyl (+/- 0.4 mg) after barbiturate induction, and curarization with pancuronium, reversed by neostigmine. In group A 2 microgram/kg naloxone I.V. was given and 1 microgram/kg I.M. 30 min. later and in group B 1 micrometer/kg I.V. and 30 min. later 0.5 micrometer/kg. Reversal of narcotic depression was good and well maintained for 60 min. in both groups, as evidenced by respiratory rate, respiratory minute volume, pHa, PaCO2. Marginal temporarily cardiovascular stimulation occurred with arousal. Tolerance was good. It is concluded that antagonisation of respiratory depression due to narcotic anesthesia is possible with small titrated dosis of naloxone.

The case is reported of a four-year-old boy with progressive muscular dystrophy who underwent anal fistulectomy under neuroleptanaesthesia with Thalamonal. Recovery was uneventful. Anaesthetic problems associated with the disease include sudden death due to myocardial involvement and high postoperative mortality due to pulmonary infection. Mental retardation and ECG abnormalities may be present and acute postoperative gastric dilatation has been reported. Narcotics or minor tranquilizers and hyoscine are recommended for premedication. Light anaesthesia should be maintained throughout surgery and minimal doses of non-depolarizing muscle relaxants may be used if necessary. Suxamethonium chloride should be avoided because muscle damage and cardiac arrest might occur.