Anesthesiology
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The authors developed a new method of intrathecal local anesthetic injection in rabbits in order to study the relationship between anesthetic concentration and impaired neurologic function. They found that none of the local anesthetics studied produced persistent neurologic damage in concentrations used clinically. ⋯ Pure solutions of relatively insoluble local anesthetics (bupivacaine and 2-chloroprocaine) failed to produce comparable neurologic or neuropathologic changes when tested at concentrations up to their solubility limits. Extensive neurologic impairment was not necessarily accompanied by equally extensive lesions in the spinal cord and nerve roots.
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Comparative Study
Bicitra (sodium citrate) and metoclopramide in outpatient anesthesia for prophylaxis against aspiration pneumonitis.
To evaluate the effect of Bicitra (Willen Drug Company, Baltimore, Maryland), a commercial preparation of sodium citrate and metoclopramide, on gastric contents 150 elective outpatients allocated into six groups with 25 patients in each group were studied. Patients in Group 1 served as controls. Patients in Groups 2, 3, 5, and 6 received Bicitra, po, either 15 ml (Groups 2 and 5) or 30 ml (Groups 3 and 6). ⋯ The addition of metoclopramide 10 mg, iv, to Bicitra reduced the proportion of patients with a gastric volume greater than or equal to 25 ml in Groups 5 and 6 to 28 and 36%, respectively. Metoclopramide (Group 6) independently reduced mean gastric volume (15.6 ml vs. 32.7 ml) and the proportion of patients with a gastric volume greater than or equal to 25 ml (20% vs. 36%). Bicitra and metoclopramide combination significantly reduced the proportion of patients with gastric contents greater than or equal to 25 ml with pH less than or equal to 2.5.