Neuroleptanalgesia for awake pronation of surgical patients

Pronation of anesthetized patients may result in complications. Neuromuscular block increases the risk. To minimize the risk, the authors devised a technic of "awake pronation," evaluating its feasibility, in 11 consecutive patients in a 1-year period for 12 operations; all attempts were successful and without complicatons. Neuroleptanalgesia is achieved with droperidol and fentanyl, topical anesthesia of the upper airway is induced with lidocaine, awake intubation is performed orotracheally under direct vision, and pronation is accomplished with patient cooperation.