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The tolerance to local anesthetics injected intravenously
ABSTRACTS
OF CURRENT
LITERATURE
407
‘Ueber die VerWglichkeit von LocalanLsthetica bei IntravenSser Verabreichung. Tolerance to Local Anesthetics Injected Intravenously.) Peter Adler and Sandor. Schtveiz. med. Wchnsehr. 77: 413, J947.
(The Georg
Cocaine is a nerve poison (Meyer and Gottlieb). When the drug is applied topically on mucous tissues it shops an elective effect on the sensory nerve fibers since it sets more rapidly on them than on the motoric nerve terminals; rno~eo~e~~ the thresllold concentration of cocaine is lower for the sensory fibers than for those of the motoric type. When this drug is administered intravenously, it acts not only upon the sensory nerve terminals, but also 0n all parts of the nervous system including the central nervous system. In acute poisoning 0f cocaine or cocaine substitutes, epileptiform convuhsions appear more or le#ss markedly according
to the concentration
of the drug and to the degree of tolerance
of the individual.
The epileptic himsdf is believed to be intolerant to cocaine administration. Epileptiform convulsions are typical not only of the acute poisoning of cocaine, but also of cocaine substitutes.
In view of the similar toxicologic picture which is offered by tlze cocaine and cocaine substitutes, the authors undertook a series of experiments on man to lind out whether: (1) the epileptic shows an ~ntol~~~nee to the cocaine substitutes, (2) the so-called e~~er~rnenta~ ooeaine epilepsy might be produced by means of cocaine substitutes. For these experiments, of p-aminoben~.yl”diet~lyl-amino-ethan01) and Pereain0 Novoca.in (hydrochloride chloride of diethylethylenediamide of alfa-butyloxycinchoninic acid) were chosen.
(hydroThe auin the resorption of
thors injected these substitutes intravenously, partly to avoid fluctuations the drug and partly to achieve comparable results. On the basis of their observations on fourteen epileptics and forty-seven nonepileptics, they concluded that: (I) epileptics are not less tolerant than the nonepileptics to cocaJne. substitutes, (2) epileptiform convulsions prod.ueed by acute poisoning of cocaine substitutes are ‘more in the fore in the case of an epileptic, whereas the nonepileptic generally sh0ws signs of malaise, nausea, pallor, profuse perspiration, mydriasis, and accelerated pulse with hypertensioll. The authors found remarkable tolerance to high doses of Novocain and Percaine admi~s~ered jntravellously both by The toxic dose of Percaine in the case of nonepilepties and epiepileptics and nonepileptics. Thus, the threshold of toxicity was almost identical leptics was 1.1-1.3 mg./kg. body weight. In the administration of Novocain, definite oscillations were noted by the in both conditions. authors in the case of epileptics and nonepileptics, with regard to t.he level of t[lre&,ld. This is represented in the following figures: Toxic Novocain dose: Nonepileptic, Epileptic,
2.7-10.7 mg./kg. 2.2- 9.1 mg./kg.
the toxic
body weigbt body meight A. G. W.
ROENTGENOLOGY A Simple Radiodontic
Technique.
Rene 1Rochon.
J. Canadian
D. A. 12: 67-73, February,
1946. Dr. Bocbon, Dean of the University of Detroit, gives some fo0d for thought tathe genHe stresses the necessity of full mouth x-ray examination for eral practitioner of dentistry. every patient. Many dentists pass it up be&se their past train,iug in radiography has made it difi?cult for them to overcome their own personal prejudices as well as their patient’s resistance to the idea. The best way’to establish a custom is to teach it to young people, so radiography%s it should be practiced has been taught in his s&001. A technique has been evolved ivhi&.can produce a better complete survey within a half hour. Variable factars have been!@uti;ollsd Because of the accuracy of the t&hnique, so completely that angulation is the only variable. h0 &ims that radiograms will be almost duplicates, .whether they are taken today, tomorrbw, or next year; therefore, tissue changes can be determined accura,t.ely.
OF CURRENT
LITERATURE
407
‘Ueber die VerWglichkeit von LocalanLsthetica bei IntravenSser Verabreichung. Tolerance to Local Anesthetics Injected Intravenously.) Peter Adler and Sandor. Schtveiz. med. Wchnsehr. 77: 413, J947.
(The Georg
Cocaine is a nerve poison (Meyer and Gottlieb). When the drug is applied topically on mucous tissues it shops an elective effect on the sensory nerve fibers since it sets more rapidly on them than on the motoric nerve terminals; rno~eo~e~~ the thresllold concentration of cocaine is lower for the sensory fibers than for those of the motoric type. When this drug is administered intravenously, it acts not only upon the sensory nerve terminals, but also 0n all parts of the nervous system including the central nervous system. In acute poisoning 0f cocaine or cocaine substitutes, epileptiform convuhsions appear more or le#ss markedly according
to the concentration
of the drug and to the degree of tolerance
of the individual.
The epileptic himsdf is believed to be intolerant to cocaine administration. Epileptiform convulsions are typical not only of the acute poisoning of cocaine, but also of cocaine substitutes.
In view of the similar toxicologic picture which is offered by tlze cocaine and cocaine substitutes, the authors undertook a series of experiments on man to lind out whether: (1) the epileptic shows an ~ntol~~~nee to the cocaine substitutes, (2) the so-called e~~er~rnenta~ ooeaine epilepsy might be produced by means of cocaine substitutes. For these experiments, of p-aminoben~.yl”diet~lyl-amino-ethan01) and Pereain0 Novoca.in (hydrochloride chloride of diethylethylenediamide of alfa-butyloxycinchoninic acid) were chosen.
(hydroThe auin the resorption of
thors injected these substitutes intravenously, partly to avoid fluctuations the drug and partly to achieve comparable results. On the basis of their observations on fourteen epileptics and forty-seven nonepileptics, they concluded that: (I) epileptics are not less tolerant than the nonepileptics to cocaJne. substitutes, (2) epileptiform convulsions prod.ueed by acute poisoning of cocaine substitutes are ‘more in the fore in the case of an epileptic, whereas the nonepileptic generally sh0ws signs of malaise, nausea, pallor, profuse perspiration, mydriasis, and accelerated pulse with hypertensioll. The authors found remarkable tolerance to high doses of Novocain and Percaine admi~s~ered jntravellously both by The toxic dose of Percaine in the case of nonepilepties and epiepileptics and nonepileptics. Thus, the threshold of toxicity was almost identical leptics was 1.1-1.3 mg./kg. body weight. In the administration of Novocain, definite oscillations were noted by the in both conditions. authors in the case of epileptics and nonepileptics, with regard to t.he level of t[lre&,ld. This is represented in the following figures: Toxic Novocain dose: Nonepileptic, Epileptic,
2.7-10.7 mg./kg. 2.2- 9.1 mg./kg.
the toxic
body weigbt body meight A. G. W.
ROENTGENOLOGY A Simple Radiodontic
Technique.
Rene 1Rochon.
J. Canadian
D. A. 12: 67-73, February,
1946. Dr. Bocbon, Dean of the University of Detroit, gives some fo0d for thought tathe genHe stresses the necessity of full mouth x-ray examination for eral practitioner of dentistry. every patient. Many dentists pass it up be&se their past train,iug in radiography has made it difi?cult for them to overcome their own personal prejudices as well as their patient’s resistance to the idea. The best way’to establish a custom is to teach it to young people, so radiography%s it should be practiced has been taught in his s&001. A technique has been evolved ivhi&.can produce a better complete survey within a half hour. Variable factars have been!@uti;ollsd Because of the accuracy of the t&hnique, so completely that angulation is the only variable. h0 &ims that radiograms will be almost duplicates, .whether they are taken today, tomorrbw, or next year; therefore, tissue changes can be determined accura,t.ely.