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August 4, 1978

Toxic Effects of Local Anesthetics

Author Affiliations

The Mason Clinic Seattle

JAMA. 1978;240(5):434. doi:10.1001/jama.1978.03290050024003

To the Editor.—  The article "Toxic Effects of Local Anesthetics" by Rudolph H. de Jong, MD (239:1166, 1978), is, as with the majority of the articles and books by Dr de Jong, excellent. However, the implication that diazepam (Valium) should be used prophylactically to prevent systemic toxic reactions in humans, as well as to treat them, is misleading. The studies cited by the author to support this contention were done in laboratory animals and in the research of Dr de Jong with lidocaine (Xylocaine) only. These data have been extrapolated to humans, but the author has no substantial data to support that, in fact, what applies in laboratory animals also applies in humans. To the best of my knowledge, he has not taken this valuable research into a clinical setting to confirm that in humans, diazepam is as effective as in animals, and, furthermore, that the dosage or the time