Systemic Use of Local Anesthetics

J. Eugene Ruben, MD
JAMA. 1966;197(8):665-666. doi:10.1001/jama.1966.03110080105042.
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To the Editor:—  Dr. John Adriani's otherwise excellent article (196:405, 1966) "Reactions to Local Anesthetics" contains one statement which I consider to be incorrect:The systemic effects of local anesthetics are of very little use clinically. Some physicians use them intravenously, but other drugs are more effective. Thus, there is little justification for using these drugs systemically.Since 1947 we have been using 0.5% or 1% procaine intravenously in combination with thiopental, nitrous oxide, ether, and cyclopropane in various combinations. We find intravenous administration of procaine of value because:

  1. It suppresses respiratory tract secretions so effectively that suction through the endotracheal catheter is almost never necessary.

  2. It suppresses sweat gland secretions so that the skin remains warm and dry and the loss of fluid and electrolytes during surgery is minimized.

  3. It decreases somatic and autonomic sensitivity, so that noxiousreflexes are minimized and the amount


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