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In this book the author reviews the history of spinal anesthesia, the biochemistry of the cerebrospinal fluid, the pharmacology of the drugs used for spinal anesthesia, the technic of lumbar puncture and spinal anesthesia, the use of this form of anesthesia in obstetrics and in gynecology, and the effect of spinal anesthesia on the intermediary metabolism. He advises against the use of morphine and other alkaloids preliminary to the use of spinal anesthesia because all alkaloids depress the respiratory center. He employed nupercaine in 1,200 cases and prefers the sitting posture for the insertion of the anesthetic. However, in pregnant women near or at term, the lateral position must be employed. The sensitiveness of gravid women to spinal anesthetics is definitely increased, because during gestation there is a greater tendency toward bleeding, an increased permeability of the blood vessels, a more ready transfer of material from the cerebrospinal fluid into
Lumbalanästhesie in der Geburtshilfe und Gynäkologie mit besonderer Berücksichtigung der Biochemie des Liquors und der Blutliquorschranke. JAMA. 1934;103(16):1258-1259. doi:10.1001/jama.1934.02750420070028