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JAMA 100 Years Ago
May 5, 2004

SPINAL COCAINIZATION.

JAMA. 2004;291(17):2146. doi:10.1001/jama.291.17.2146-c

In a recent article, Bier, whose name is familiar as the perfector of Corning's suggestion of anesthesia of the spine, announces that with the use of the suprarenal preparations he has relieved the operation of many if not all of its dangers. Their use, he says, renders it possible to insure strict localization of the cocain to the point where its action is desired. It had been known before that adrenalin injected into the lumbar sac was tolerated well by animals, and Bier applied this fact to his clinic. He has also utilized the method in one hundred and twenty-one cases in patients ranging in age from sixteen to eighty, mostly men, much debilitated and unable to undergo general anesthesia. In no case was there any unfortunate complication save a rather severe headache, lasting for a considerable period in a few instances. . . . As regards its comparative comfort, he admits that while some patients express for it a preference, others prefer general anesthesia, and some find both equally uncomfortable. It would appear from this evidence that the probability of spinal anesthesia—a name to which Bier objects—has probably come to stay among surgical procedures, but it will be desirable to have other testimony from various sources to confirm the fact of its absolute innocuousness.

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