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May 8, 1943

Regional Analgesia for Intra-Abdominal Surgery With Special Reference to Amethocaine Hydrochloride

JAMA. 1943;122(2):141. doi:10.1001/jama.1943.02840190071032

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This monograph describes lucidly and in detail the author's technic of "analgesia" for upper abdominal operations for patients who are seriously ill. The method is reminiscent of that published by Bartlett (R. W.: Bilateral Intercostal Nerve Block for Upper Abdominal Surgery, Surg., Gynec. & Obst.71:194 [Aug.] 1940), although several modifications are utilized. In the lateral position the sixth to twelfth intercostal nerves are blocked on each side by an injection of 1:1,000 concentration of pontocaine below the rib at a point 4 fingerbreadths from the vertebral spines. Then a posterior splanchnic block with 1:2,000 concentration of pontocaine is performed with the patient in the same position. The author recommends the use of carefully individualized doses of opiates given intravenously. Doses of omnopon varying from 1/3 to 1 2/3 grains (0.02 to 0.10 Gm.) or morphine 1/6 to 3/4 grain (0.01 to 0.05 Gm.) are suggested. One may question

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