The surgery of oral diseases and malformations : their diagnosis and treatment / by George Van Ingen Brown.

  • Brown, George van Ingen, 1861-1948.
Date:
1912
Catalogue details

Licence: In copyright

Credit: The surgery of oral diseases and malformations : their diagnosis and treatment / by George Van Ingen Brown. Source: Wellcome Collection.

    23/792 (page 19)
    Stovain and Novocain (0.5 per cent. soKition).—JMainoli' strongly urges a wider use of this mode of anesthesia in major as well as minor operations. He has had no local difficulties, e. </.,skin slough- ing, but he seldom uses a stronger solution than 1 per cent, given in a 10 c.c. syringe. It is well to remember, if the syringe is ster- ilized in an alkaline solution, that stovain becomes chemically altered and is physiologically inert. Lately he has discarded adrenalin, as he claims it gives no real advantage. Novocain, he holds, lessens the smarting which stovain sometimes causes. Novocain.—A 1 per cent, solution of novocain gives local insen- sibility to pain, with few if any objectionable features. Its rela- tive safety is shown by the following table prepared bvLe Borccj,- as a result of his investigations of various preparations used as substitutes for cocaine: “If the toxicity of cocaine be represented as 1, then The toxicity of alypin . . . . The toxicity of nirvanin The toxicity of stovain’ The toxicity of tropacocain The toxicity of novocain The toxicity of rcta-eucain lactate will repre.sent 1.25 will represent 0.814 will represent 0.625 will represent 0.500 will represent 0.490 will represent 0.414” Quinine-Urea Hydrochloride. — The advantages claimed for ciuinine-urea hydrochloride as a local anesthetic are: (1) Any operation ordinarily done under cocaine can be done with quinine and urea. (2) The duration of anesthe.sia with 0.5 to 1 per cent, solutions is longer than when cocaine is used. (.3) Solutions of this strength (1 per cent.) cause some induration. (4) Ihiion may be a little delayed by a fibrinous exudate when the stronger solu- tions (1 per cent, or over) are used. (5) In operations about the anus and in tonsillectomies it is the anesthetic of choice, as it has a hemostatic effect and the pain of dressings is avoided. Its advantages over cocaine are: (1) Its absolute safety. (2) The duration of anesthesia. (3) Its hemostatic effect. II. F. Graham tried this combination in 17 cases. A 1 ]ier cent, .solution was generally used (made from the 2-grain tablets of 1’., I). & Go.), and the solution boiled befon* use. As a result of * Rritish .Medical .Journal, November 19. 1910, quoted from Iliforimi Mcdica. * Ibid., March 2. 1909. > Ibid.