Evipal Soluble for the Control of Convulsions from Novocaine Poisoning *

The results of laboratory studies to determine the antidotal value of various drugs for symptoms of poisoning following the use of cocaine as a local anesthetic were published by Tatum and his collaborators' in 1925. Their research proved that the barbiturate sedatives then available had a remarkable effect in increasing the minimal lethal dose of cocaine for dogs, and in controlling convulsions resulting from overdosage. In recent years, the value of the pre-operative use of such drugs in increasing the tolerance for local anesthetics of the cocaine-procaine group has been repeatedly emphasized in medical literature by Miller,4 Waters,6 Lundy,2 Maloney,3 and other well-known authorities on anesthesia. The specific anti-spasmodic property of the barbiturates is now noted for prevention of the convulsions developing from individual low tolerance for, or overdosage of, local anesthetics. Since the subcutaneous use of cocaine has been generally discarded in favor of the less toxic drugs of the procaine group, serious reactions are far less common, despite the modern greatly increased use of local anesthesia. When used in the dilute 0.5 per cent solution, large quantities of the fluid can generally quite safely be injected into the body tissues, as needed for the adequate control of pain during surgical operations. However, toxic symptoms may appear in patients whose tolerance for the drug is low. As described by Maloney,3 the value of the barbiturates under these circumstances is probably limited to the symptoms arising from overdosage by the relatively slow absorption method from local infiltration of normal tissues. The toxic effects are, those of stimulation, apprehension, excitement, increased rate of respiration, and donic convulsions. If not corrected the condition will progress to respiratory failure and death.