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The value of avertin
'i60
AMERICAN
JOLlRP;AL
OF
OBSTETRICS
the anesthetic and in 50 cases the results the uterus was found to be well contracted extraction of the child was easy and in taneously. The children cried immediateiy was smooth.
AND
GYNECOLOGY
were very good. In all of these cases when the abdomen was opened. The 17 easea, the placenta separated sponafter birth. The postoperative recovery J.
Edwards,
George
:
Avertin
Narcosis.
Brit.
Med.
Jour.
2: 213,
I'.
GREENHILL.
1929.
The merits of avertin narcosis for operations are those of rectal anesthesia combined with those of deep preliminary and subsequent narcosis. The dosage where there is no marked weakness or general infection is 0.1 gm. per kilo of body weight. Doses of 0.125 gm. and 0.15 gm. occasionally give trouble. The total dose is from 6 to 8 gm. The drug is provided in a concentrated solution with amylene hydrate, 1 gm. in 1 C.C. Small quantities of inhalation anesthetics ‘are usually necessary and it requires an experienced anesthetist to control the su8perimposed anesthesia. The amount of ether and chloroform used will be measured in draehms rather than ounces. The duration of the narcosis is from lye to 2 hours from the time of injection. Four hours from the start the patient is usually quite conscious of her surroundings. When return to consciousness is prolonged the treatment consists of injections of lobeline, administration of CO, and 0, mixtures and injections of ephedrine. During both the period of induction and that of recovery the relaxed jaw and tongue should be watched. Avertin is contraindicated in disea,ses of the kidney, liver, colon, and where there is thyroid deficiency. It is excreted almost entirely by the liver and kidneys. Morphine should not be used prior to injection. During narcosis there is a fall in blood pressure of lo-20 mm. as occurs in deep sleep. There are no definite changes in the pulse rate. Breathing is shallow a.nd the rate normal or slightly quickened. A slight cyanosis is usually observed. G. E.
Naujoks:
The
Value
of Avertin.
Monatschr.
f. Geburtsh.
n. Gytik.
HUDSON.
84:
97, 1930.
The author does not believe that all the fatalitiea recorded as avertin deaths in the literature because they followed avertin anesthesia were due to this drug. Many of the deaths if not due to excessive doses or faulty technic were caused by defective constitution. In obstetrics, avertin produces painless labor at the end of the first stage and during the second stage. It is the best narcotic for patients with eclampsia and is better than the Stroganoff treatment for this complication. J. CJnnell,
J. S. M.:
The
Use
of Avertin
in
Childbirth.
The
P.
Lancct
GREENHILL. 2:
184,
1930.
Avertin may be nsed in every case where antenatal examination indicates norIt may be mal parturition, except when the presenting part is on the perineum. Its usefulness is increased used also while preparing for operative interference. in primiparas. Avertin does not produce painless labor but it makes “things so easy for the patient.” The author encourages the general practitioner to give this analgesic agent a requires little apparatus, has no “aftertrial. This preparation is easily given, results, ” and is reasonably safe, although not entirely “foolproof.” H.
C. HESSELTINE.
AMERICAN
JOLlRP;AL
OF
OBSTETRICS
the anesthetic and in 50 cases the results the uterus was found to be well contracted extraction of the child was easy and in taneously. The children cried immediateiy was smooth.
AND
GYNECOLOGY
were very good. In all of these cases when the abdomen was opened. The 17 easea, the placenta separated sponafter birth. The postoperative recovery J.
Edwards,
George
:
Avertin
Narcosis.
Brit.
Med.
Jour.
2: 213,
I'.
GREENHILL.
1929.
The merits of avertin narcosis for operations are those of rectal anesthesia combined with those of deep preliminary and subsequent narcosis. The dosage where there is no marked weakness or general infection is 0.1 gm. per kilo of body weight. Doses of 0.125 gm. and 0.15 gm. occasionally give trouble. The total dose is from 6 to 8 gm. The drug is provided in a concentrated solution with amylene hydrate, 1 gm. in 1 C.C. Small quantities of inhalation anesthetics ‘are usually necessary and it requires an experienced anesthetist to control the su8perimposed anesthesia. The amount of ether and chloroform used will be measured in draehms rather than ounces. The duration of the narcosis is from lye to 2 hours from the time of injection. Four hours from the start the patient is usually quite conscious of her surroundings. When return to consciousness is prolonged the treatment consists of injections of lobeline, administration of CO, and 0, mixtures and injections of ephedrine. During both the period of induction and that of recovery the relaxed jaw and tongue should be watched. Avertin is contraindicated in disea,ses of the kidney, liver, colon, and where there is thyroid deficiency. It is excreted almost entirely by the liver and kidneys. Morphine should not be used prior to injection. During narcosis there is a fall in blood pressure of lo-20 mm. as occurs in deep sleep. There are no definite changes in the pulse rate. Breathing is shallow a.nd the rate normal or slightly quickened. A slight cyanosis is usually observed. G. E.
Naujoks:
The
Value
of Avertin.
Monatschr.
f. Geburtsh.
n. Gytik.
HUDSON.
84:
97, 1930.
The author does not believe that all the fatalitiea recorded as avertin deaths in the literature because they followed avertin anesthesia were due to this drug. Many of the deaths if not due to excessive doses or faulty technic were caused by defective constitution. In obstetrics, avertin produces painless labor at the end of the first stage and during the second stage. It is the best narcotic for patients with eclampsia and is better than the Stroganoff treatment for this complication. J. CJnnell,
J. S. M.:
The
Use
of Avertin
in
Childbirth.
The
P.
Lancct
GREENHILL. 2:
184,
1930.
Avertin may be nsed in every case where antenatal examination indicates norIt may be mal parturition, except when the presenting part is on the perineum. Its usefulness is increased used also while preparing for operative interference. in primiparas. Avertin does not produce painless labor but it makes “things so easy for the patient.” The author encourages the general practitioner to give this analgesic agent a requires little apparatus, has no “aftertrial. This preparation is easily given, results, ” and is reasonably safe, although not entirely “foolproof.” H.
C. HESSELTINE.