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Safe Anesthesia for Peroral EndoscopyA Subsequent Report
WILLIAM P. KLEITSCH, M.D.
AMA Arch Otolaryngol. 1959;69(1):45-47.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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The agents most widely used to produce anesthesia for peroral endoscopy are tetracaine (Pontocaine) and cocaine. They are potent drugs and both are toxic in relatively small doses. When they are instilled into the tracheobronchial tree, the absorption of these agents approaches the speed of an intravenous injection. The combination of toxicity and rapid absorption makes untoward reactions to the anesthetic relatively common, and occasionally a death will result.4
Because the hazard has been recognized, such reactions to cocaine and tetracaine have been studied in detail.1 The conclusions, which correspond to clinical experience, suggest the untoward reactions to these topical anesthetic agents are a result of overdosage rather than drug sensitivity. Rigid dose control is, therefore, required to reduce the hazards of toxicity. This is achieved by reducing the concentration of the solution and limiting the volume administered so that rigid maximum dose control is achieved.
Unfortunately, reducing
. . . [Full Text PDF of this Article]
Author Affiliations
Omaha
From the Surgical Service of the Veterans Administration Hospital, Omaha, and of the Creighton University School of Medicine, and the University of Nebraska College of Medicine.
Footnotes
Submitted for publication March 19, 1958.
Read before the 17th Congress of the International Society of Surgery, Mexico, D. F., Oct. 25, 1957.
The tripelennamine, Pyribenzamine, was made available by the Ciba Pharmaceutical Company.
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