Concentration of Procain in Cerebrospinal Fluid of Human Being After Subarachnoid Injection.

Abstract

could not be eiitirely attributed to the use of intracain. I t did suggest that the drug was of comparatively low toxicity and that the incidence of complications following spinal anesthesia would not be increased with intracain.S u m m a r y NTRACAIN (Squibb) has been shown experimentally to posscss 1 advantages over procain hydrochlorid for infiltration and regional anesthesia.Clinical investigations have largely substantiatcd the laboratory findings. T h e appl'cation of the drug to spinal anesthesia is herein reported from a brief and critical clinical study.Thc prclimiiiary observatioiis during 100 anesthesias indicate that intracain may be a useful drug for spinal anesthesia. Small doses may he used. The onset of sensory anesthcsia is very rapid. Motor paralysis is slo\ver and less cffectivc than with proc:iin. Intracnin is rapitlly tlissolvetl in spinal Ruid but i f the solution is shaken or exposed to the air for several minutes it may become cloudy.Intracain may be administered for spinal anesthesia with techniques that ;ire similiar to those recommended for procain. A 2.5 per cent solution in spinal fluid was found to be satisfactory.The duration of anesthesia with intracain is not proportionate t o the amount of drug injected. Doses of 25 t6 75 mgm. produced sensory anesthesia f o r 45 to 60 minutes. Constant results were not obtaincd with smaller amounts. Effective anesthesia following doses larger than 100 mgm. was of shorter tlur;rtion than might be expected from corresponding amounts of procain. h i r i n g this investigation few operations were attempted involving structures abovc the lower abdomen. No obscrvations ind:catcd any particular advantage for the drug during upper abdominal operations or those requiring niuch more th:in one hour of ancsthesia.Intracain w:is given to patients in good physical condition. Opcrations completed were mostly siniple procedures regularly attended by few complicat:ons. In this small serics of cases ;inesthetic complications were infrequent :ind not serious. The effects upuii circulation and respiration resembled those iroin procain. Few postoperative complications Acre obscrvetl. There wns no suggestion that the use of intracain would increase the postoperative inorliidity o r mortality of spinal anesthesia.Intracain posscsses some advantages :is ;L mild anesthetic agent, i~srful in low tlusagc and low concentrations, for surgical procedures that involvc no structures above the lower abtlnmen.377 FInsT AVE. Bibliography 1. Alclntyre, :\. It. an11 Scrvcts. I< I: . : J . Plrariir. a i d L.1-p. Thcr.op.. 6 l : A 1Y37. 2, Rovenstine, E. A. am1 C'nllru. S. C,: Cur. :603 (October) 1938. O S T E R AND HIS ASSOCIATES studied t h e concentration of procainEach pa-E tient received a n injection of 150 mg. of procain liytlrocliloritl dissolved in 3.5 cc. of cerebrospinal fluid a t t h e interspacc betwecn the second a n d the third lumbar vertebra. T h e concentration of the anesthetic w a s determined up t o ninety minutes after tlie injection: (1) a t the site of inject...