To the Editor:—
In the Nov. 1, 1958, issue of The Journal, pages 1224-1225, there is a clinical note entitled, "Arterial Thrombosis with Gangrene After Use of Promazine (Sparine) Hydrochloride," by Opinsky and others, in which I believe an inaccurate conclusion was drawn. It would seem that the cases represent examples of intra-arterial rather than intravenous injection. The same sequence of events will occur after any highly acid or alkaline compound has been injected intra-arterially. The anesthesiologist is well aware of this fact. Also, it is easy, and sometimes fantastically so, to enter the brachial artery or its branches when the antecubital space is used to give an intravenous injection. Several cases of gangrene occurring after the intraarterial injection of pentothal sodium have been reported. An article in the British Journal of Anaesthesia (Baillie, 30:373-374 [Aug.] 1958) discusses this problem. I, therefore, disagree with the last statement in author's