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BALANCED ANALGESIA FOR THE POOR-RISK PATIENT UNDERGOING THORACIC SURGERY

Crisostomo C. Santos, M.D.; Robert B. Sweet, M.D.
JAMA. 1958;168(15):1977-1982. doi:10.1001/jama.1958.03000150019005.
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The term "balanced analgesia" implies the production of anesthesia with use of several agents, often administered by different routes, which are detoxified and excreted in several different ways. In brief, it is simply balanced anesthesia minus true hypnosis. In dealing with a poor-risk patient the friendly and informal approach to the patient is the most humane. Most of these patients are fully cognizant of their precarious condition before they elect to undergo an operative procedure. It is a well-established clinical thesis that shock or functional impairment of the circulation will often be induced in borderline patients by general anesthesia, particularly during prolonged procedures. There are four merits of a balanced analgesic technique: 1. The anesthetic agent and supplemental drugs used are almost universally acceptable to all patients. 2. There is minimal disturbance of physiologic mechanisms. 3. A relatively wider margin of safety for the patient and optimal working conditions for the surgeons are provided. 4. There is a relatively shorter and uneventful postoperative course.

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