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Light general anaesthesia combined with neuromuscular blockade and artificial pulmonary ventilation is current practice for many major surgical operations because anaesthesia is easily controlled and serious unwanted effects are infrequent. However, if the patient’s cooperation is required, as in some neurosurgical procedures, techniques producing effective analgesia without unconsciousness are desirable. A search for drugs which might permit this has been partially successful with the synthesis of two groups of drugs, a group of very potent analgesics and a group of neuroleptics. These may be used in combination to produce analgesia and emotional detachment with loss of spontaneous activity, and yet leave the patient obedient to commands. The combination is notably free of troublesome cardiovascular effects and is therefore claimed to be suitable for poor risk patients. It may be used alone or with conventional general anaesthesia.

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