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September 17, 1932

OBSERVATIONS ON A PATIENT TO WHOM SPINAL ANESTHESIA WAS ADMINISTERED FIVE TIMES WITHIN THIRTY-EIGHT HOURS

JAMA. 1932;99(12):993-994. doi:10.1001/jama.1932.27410640003010a

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Abstract

The history reported here illustrates many interesting points in urinary physiology and suggests that spinal anesthesia, even though frequently repeated, is harmful only in proportion to the lack of skill of the anesthetist. The urologic history is long and has been greatly condensed.

R. M., a man born in 1891, a railroad employee, had hematuria and attacks of colic in the right loin for four years when, in 1922, the right kidney was removed. It was said to contain a large stone. The following year he had a urethral discharge, which continued until 1928. An abscess discharged through the perineum. In 1929 he was first seen by Dr. Keyes and operated on twice under spinal anesthesia (procaine hydrochloride) at a four weeks interval for urethral stricture and perineal abscess. Both lesions were relieved, though the perineum, after healing promptly and almost completely, still showed a pin hole fistula in the

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