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May 5, 1956


JAMA. 1956;161(1):95-96. doi:10.1001/jama.1956.02970010097029

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To the Editor:—  An abstract of an article entitled "Spinal Anesthesia in More Than 500 Vaginal Deliveries," by Marvin Elkins, appeared on page 513 of The Journal, Feb. 11, 1956. It is not appreciated by many readers that publication of an abstract in The Journal does not imply editorial endorsement. Frequently techniques will be used on the basis of such abstracts, with or without study of the original article. In this instance, a "simple and practical technique of spinal anesthesia" is presented. The dosage of 20 to 22 mg. of tetracaine is recommended. In view of the numerous reports of competent clinical investigators and of practicing anesthesiologists, this seems to me to represent a large overdose. In the average parturient woman, I believe this could readily result in either high spinal anesthesia, with respiratory paralysis, or in an unduly high concentration of the drug surrounding the distal spinal cord and

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