Innovar - Fentanyl

The observation that patients who had received Innovar (fentanyl/droperidol) before anaesthesia appeared to have prolonged suxamethonium effects, seen as apnoea, prompted further study of this possible interaction. An average delay in recovery from neuromuscular blockade of 36% to 80% was seen in two studies. Another study showed that the droperidol component of Innovar was probably responsible for this interaction. 

The neuroleptic droperidol possesses antipsychotic, sedative, and antishock action. It potentiates the action of drugs for narcosis. In psychiatric practice, droperidol is used for psy-chomotor excitement and hallucinations. The principal use of this drug lies in anesthesiology for neuroleptanalgesia in combination with fentanyl. It is used in premedication as well as in surgical operations and post-operational circumstances. Synonyms of this drug are talam-onal, droleptan, leptofen, innovar, and others. 

The combination of droperidol and fentanyl is a fixed ratio preparation called innovar. Since droperidol is a neuroleptic substance, innovar is said to produce neurolept analgesia if combined with a more potent anesthetic, innovar produces neuroleptic anesthesia. A neuroleptic has adrenergic blocking as well as sedative, antiemetic, and anticonvulsant properties. Since innovar can cause extrapyramidal muscle movements, it is contraindicated in Parkinson s patients. 

By far the most widely used preparation of this type is Innovar , a combination of the neuroleptic, droperidol, and the analgesic, fentanyl. Some 30 articles appeared during 1966 describing its use in humans with or without nitrous oxide. 

Neuroleptic analgesia is so called because the combination of a major tranquilizer, a neuroleptic dmg, and a potent opiate produces an anesthetic state characterized by sedation, apathy, and mental detachment (see Psychophaemacological agents) (152). Innovar [8067-59-2]y a combination of dropetidol [548-72-2], C22H22FN3O25 (19) and fentanyl (9) citrate, is used for procedures that do not require muscle relaxation. However, the onset of action is slow. 

The drug exhibits relatively low therapeutic potency, medium extrapyradimal toxicity, high sedative effect, and above all high hypotensive action. However, it is most frequently employed in the form of its combination [Innovar ] along with the narcotic agent fentanyl [Sublimaze ] preanaesthetically. 

Moore GB, Ciresi S, Kallar S. The effect of Innovar versus droperidol or fentanyl on the duration of action of succii lchohne. J Am Assoc Nurse Anes0t (1986) 54,130-6. 

The effects of fentanyl and droperidol with fentanyl in depressing respiration were studied in 29 subjects undergoing nitrous oxide anaesthesia. The combination of the drugs used was the proprietary preparation Innovar containing fentanyl 0.05 mg/ml and droperidol 2.5 mg/ml. In the study patients received fentanyl, alone or as Tn-novar , 1.5 pg/kg by intramuscular injections... 

Both fentanyl and Innovar depressed the slope of the rebreathing carbon dioxide response curve to 42% 6 of the values obtained in the same subjects when awake. After the last injection of fentanyl or the fentanyl/droperidol combination the slope of the curve increased to 77% 8 of the control level but after reaching a normal level the respiratory depression recurred, the slope of the curve falling to 55% + 5 of the control value. Subsequently the slope of the curve returned to near normal levels. 

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