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February 23, 1963


JAMA. 1963;183(8):713. doi:10.1001/jama.1963.03700080121033

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Analgesia in Arteriosclerotic Patients.  —P. R. Bromage, Assistant Professor of Anesthesia at McGill University, reported (Brit Med J, p 1634 [Dec 22] 1962) that "Injection of local anaesthetic solutions into the spinal extradural space results in a segmental type of analgesia. In normal subjects the number of analgesic dermatomes can be predicted with an accuracy of 15 to 30% in terms of age and the concentration and volume of local anaesthetic used. The amount of local anaesthetic required to block a given area declines steadily after the second decade, in a manner reminiscent of some other curves relating biological phenomena to age."Fifty-three patients with occlusive vascular disease reacted abnormally to epidural analgesia. They behaved as if they were 25 to 50 years older than their chronological age, or as if the injected solution had been twice the concentration actually used. In these patients segmental analgesia spread one and a

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