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LOCAL INFILTRATION ANAESTHESIA IN SPINE SURGERY
Joseph A. Freiberg; Robert Perlman
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Orthopaedic Division of the Surgical Department of the College of Medicine of the University of Cincinnati, and the Orthopaedic Services of the Cincinnati General Hospital, the Children's Hospital, and the Jewish Hospital
1943 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1943; 25:145-152 
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Abstract

1. Local infiltration anaesthesia with procaine solution and adrenalin is the preferred anaesthesia for most spine operations including fusions, laminectomies, and combined procedures.

2. Local infiltration anaesthesia with procaine should be preceded by the administration of a barbiturate as a mild sedative, but primarily to prevent procaine reactions.

3. The introduction of the procaine solution through drill holes reduced or eliminated endosteal pain caused by the motor saw or osteotome, when cutting full-thickness tibia! grafts.

4. It is suggested, by the last two cases in this series, that equal amounts of the solution, 0.5 per cent. procaine with adrenalin is as satisfactory an anaesthetic agent for infiltration anaesthesia as 1-per-cent. procaine with adrenalin.

5. In a recent series of fifty-four spine operations from 1939 to 1942 the incidence of complications was satisfactorily low.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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