Anesthesia. XL. The Anesthetic Action of Trifluoroethyl Vinyl Ether1

This chapter describes the circulatory effects of newer inhalation anesthetics. Some excellent reviews have appeared on the subject, the earliest being the classic review by Price (1960). A collection of papers presented at a National Academy of Sciences Symposium (Price and Cohen, 1964), discusses basic circulatory physiology as a preliminary to the effects of anesthetic agents. A more recent monograph by Price (1967) is useful to those seeking to understand, as well as to know, the circulatory effects of anesthetics. Articles by Black (1965), Tomlin (1965), and Dundee (1966) are also noteworthy. Etsten and Shimosato (1964) have described their extensive work on halothane, methoxyflurane, and other agents. Theirs was probably the first review on anesthesia and the “new” physiology of myocardial mechanics. Finally, Goldberg’S [1968 (2)] thorough account of the effects of halothane on the cardiovascular system should be read by all.

Circulatory Effects of Modern Inhalation Anesthetic Agents

Certain hydrocarbons such as ethylene and cyclopropane elicit surgical anesthesia when inhaled in sufficient concentrations. The saturated hydrocarbons of the aliphatic series do not evoke anesthesia. Anesthetic properties are conferred upon the lower members of this series of hydrocarbons by halogenation with either chlorine or bromine For example, chloroform and ethyl chloride have been used as anesthetics for more than a century. It therefore appeared prudent to determine the effect of halogenation of hydrocarbons and ethers with fluorine in order to determine what effect the presence of fluorine in the molecule would exert on the anesthetic properties of these compounds. The wisdom of this effort has been justified by the investigations of the last two decades, leading to the production of the most useful anesthetic agents containing fluorine. This chapter portrays this signal advance in the field of anesthesiology.

The Fluorinated Anesthetics

Fate of Mepivacaine in the Body: I. Whole‐Body Autoradiographic Studies of the Distribution of 14C‐labelled Mepivacaine in Mice

Phenothiazine und Azaphenothiazine als Heilmittel

HE ANESTHESIOLOGIST interested in T trying a new drug for the first time will want to know three things: Is i t safe? Is i t efficient? Is i t appreciably better than similar compounds in use at the present time? Even if the answer to the first two questions is yes, the anesthesiologist may be reticent to procure and employ the new agent if i t offers few advantages over those in common use. Whereas safety and efficiency of a new drug must be demonstrated conclusively to the Food and Drug Administration .to secure permission to market in interstate commerce, superiority over other tried and proven agents may be a more difficult feature to demonstrate. The r ecen t introduction to the American m a r k e t of trifluoroethyl v inyl ether (Fluoromar@) will cause some anesthesiologists to pose these three questions. A review of our experiences and those of others already familiar w i t h t h i s compound may assist in answering at least the first two queries.

Clinical experiences with trifluoroethyl vinyl ether anesthesia.

T IS WELL KNOWN that certain antiI histaminics possess sedative properties, and that these drugs may potentia te the effects of narcotic agents when used for preliminary medication. Recently a new antihistaminic, TacaryP, has been made available for clinical trial. The oral preparation of this compound has been released for marketing. The parenteral preparation is, at the time of this writing, still under investigation.

A double-blind study of Tacaryl as a narcotic potentiator when used for preliminary medication.

EPIVACAINE HYDROCHLORIDE is the M public name of d,l-methylpipecolic acid 2,6-dimethylanilide hydrochloride, a local anesthetic agent. This compound is a white, odorless, crystalline powder that has a salty-bitter taste and is readily soluble in water. Its molecular weight is 282.5. Mepivacaine has been evaluated by investigators in Denmark, Germany, England, C a n a d a , and the United States.' L' It has been marketed recently in this country under the trade name of Carbocaine@ and is available in 1, l t h , and 2 per cent concentrations in isotonic NaCl s o l u t i o n . Multiple-dose vials designed for use in local infiltration and conduction anesthesia contain 0.1 per cent methylparaben added as preservative. Single-dose vials, designed for use in epidural and caudal anesthesia, contain Ringer's so l u t i o n as vehicle, without preservative. METHOD OF STUDY This study was begun in the spring of 1961 and was continued for approximately 17 months. We sought specifically to delineate 7 features of the compound's safety and effectiveness : (1) onset and duration of action; (2) quality of anesthesia; (3) comparative effects of the various concentrations; (4) effectiveness with and without epinephrine; ( 5 ) diffusability; (6) tissue compatibility and toxicity; (7) effects on the cardiovascular and central nervous systems.

Clinical experiences with mepivacaine hydrochloride.

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Clinical experiences with trifluoroethyl vinyl ether anesthesia.

A double-blind study of Tacaryl as a narcotic potentiator when used for preliminary medication.

Clinical experiences with mepivacaine hydrochloride.