Max S. Sadove

Methemoglobinemia—An Effect of a New Local Anesthetic L‐67 (Prilocaine)

The formation of methemoglobinemia following use of n‐propylamino‐2‐methylpropionanilide (L‐67) was measured both in a clinical study and in animal experiments. In the study of 60 patients receiving doses of 400 to 1,200 mg, 62% developed measureable amounts of methemoglobin. The highest value found represented 18% of the total hemoglobin. Rapid reconversion to the normal pigment by methylene blue was satisfactorily achieved in both patients and animals.

Electroencephalographic Monitoring and the Anesthesiologist

A Itho ugh electroencephalographic instrumentation in the operating room has been available for many years, it has been utilized only rarely for specific tasks and has not attained any wide-spread popularity. It occupies a low priority for routine monitoring and is used much less frequently than devices that measure pulse and temperature. In the majority of American hospitals, an EEG cannot be obtained conveniently. Patients who require the test for emergency reasons may have to wait several days to get a report. There are numerous reasons for the failure of electroencephalographic monitoring to attain general acceptance.

Clinical Experience With Citanest®, a New Local Anesthetic

Citanest represents an agent which definitely justifies further study and clinical usage. It has as its primary characteristics, rapid onset, good spread, and adequate duration. At this time its greatest characteristic is our impression of a definitely wider therapeutic index as it concerns the ratio of the amount of drug that may be administered to the amount of drug that causes toxic reactions. Though methemoglobinemia may be a complication of its use in large doses, we feel that this is not a contra‐indication to the drugs use but rather a factor worthy of further study because it seems to be reversible and not significantly frequent in the usual clinical dosage range.