The ideal method of performing operations on the conscious patient without mental or physical discomfort requires a balanced use of sedatives, analgesics and anesthetics. These drugs must be administered with an exact knowledge of their dangers. Fatalities during and after local anesthesia have occurred and are occurring. While not all are avoidable, many of them are. It is my purpose in this article to discuss the use of narcotics in local anesthesia with the least possible danger to the patient.
Premedication to local anesthesia aims to diminish psychic reactions and painful sensations. In minor, ambulatory procedures it is not necessary. Before major surgical operations, the restless night, the fear and anxiety not only exhaust the patient but will cause definite bodily changes.1 As the patient is usually not in actual pain, sedatives of the barbituric acid series are sufficient. Phenobarbital, 0.5 Gm. (7½ grains), n-butylethylbarbituric acid (N.
de TAKÁTS G. THE INDISPENSABLE USES OF NARCOTICS: IN LOCAL ANESTHESIA. JAMA. 1931;96(15):1228–1229. doi:10.1001/jama.1931.27220410004014
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