THE COMBINATION OF OPIATE ANTAGONISTS AND OPIATES FOR THE PREVENTION OF RESPIRATORY DEPRESSION

¹ Department of Anesthesiology, Hospital of the University of Pennsylvania; Harrison Department of Surgical Research, University of Pennsylvania School of Medicine

Data concerning pulmonary ventilation and respiratory response to elevation in "alveolar" pCO₂ obtained from patients and subjects to whom Dromoran hydrobromide, levo-Dromoran tartrate, levallorphan tantrate or combinations of these drugs were administered intramuscularly have been presented.

In no instance was the mixture of levallorphan with levo-Dromoran in a dosage relationship of 1:1 or 1:10 capable of preventing the respiratory depression normally produced by levo-Dromoran. It is concluded that the mixture of opiates and opiate antagonists for the purpose of preserving analgesia and preventing respiratory depression is not worthwhile.

Observations are presented indicating that the measurement of respiratory rate, tidal volume, and minute volume alone may not reveal respiratory depression from narcotics. Inclusion of "alveolar" or arterial pCO₂ values and of the respiratory response to increased concentrations of inspired carbon dioxide permit a more objective evaluation.