Anesthesia in Tracheo-Bronchial Procedures

We feel that the poor results previously reported have been due to using too large an amount of the drug. The manufacturer advises that not more than one cubic centimeter of the 2 per cent solution or equivalent amounts of other strengths be instilled intratracheally. In the reactions which have been observed, amounts far in excess of this have been used. While the total amount of pontocaine used by us exceeds the advocated quantity, we feel that the addition of epinephrine to the solutions as advocated by Fussganger and Schaumann² permits this. The epinephrine slows the rate of absorption of the drug and thereby allows detoxification to take place in the liver.

From our observations we believe that pontocalne is an excellent drug for anesthesia of the upper respiratory tree if it is used properly. Reactions will continue to be observed as long as overdosages of the drug are administered.