Pre-operative alcohol infusion. The need for analgesic supplementation in chronic alcoholics

The influence of pre-operative alcohol infusion on the requirement for analgesic supplementation with fentanyl in chronic alcoholic patients was studied. The chronic alcoholic was defined as a person having a regular daily alcohol consumption of over 70 g pure alcohol for at least 3 years. The mean annual consumption in the patients studied was 52 litres pure alcohol. A positive correlation between requirement for fentanyl and alcohol consumption was found. The amount of fentanyl required to achieve satisfactory analgesia (the 'saturation dose') was significantly higher (61%) in alcoholic than in non-alcoholic patients. Once stable anaesthesia was achieved the maintenance dose was the same in alcoholic and non-alcoholic patients. Pre-operative infusion of alcohol significantly reduced the amount of fentanyl required to achieve anaesthesia in both alcoholic and non-alcoholic patients (by 25% and 29% respectively). Furthermore it prevented some of the catecholamine mediated effects, such as increase in blood pressure, heart rate and blood glucose.