CIRCULATORY EFFECTS OF ANALGESIC AND NEUROLEPTIC DRUGS IN PATIENTS WITH CHRONIC RENAL FAILURE UNDERGOING MAINTENANCE DIALYSIS

An investigation was undertaken in nineteen patients to compare the circulatory effects of droperidol and methotrimeprazine with those of four narcotic analgesics. All patients suffered from chronic renal failure and were undergoing maintenance dialysis. Fortyeight studies were carried out. Droperidol (12.5 mg and 5.0 mg) improved the cardiac output and oxygenation in ten unmedicated patients in the face of a slight fall in arterial pressure. Methotrimeprazine (10 mg and 20 mg) caused a greater fall in pressure but there seemed to be an adequately compensated increase in cardiac output in contradistinction to the one recipient of chlorpromazine 25 mg. Droperidol and methotrimeprazine had similar effects in general surgical patients. Pethidine 50 mg, morphine 10 mg, pentazocine 40 mg and fentanyl 0.075 mg all caused slight depression of oxygenation in the twenty-four recipients with chronic uraemia, but pethidine seemed to be most harmful, to these as well as eleven general surgical recipients. Pentazocine had a stimulant effect on the circulation. Fentanyl seemed to be the most sparing narcotic with respect to circulatory effects. Methotrimeprazine seemed worthy of further study for premedication in patients with limited cardiopulmonary reserve. Droperidol was the most suitable premedicant for cardiac catheterization and seemed to be especially worthy of consideration as a therapeutic agent in patients with acute pulmonary oedema.