Complications of Oral Contraception

BmmIn late 1963 I started to use prilocaine only for all kinds of local analgesic tech- niques at the county hospital in Vaxjb, Sweden.Like many others I soon discovered that it was necessary to increase its concentration to 3% for satisfactory caudal and other forms of epidural analgesia comparable to that after 2% mepivacaine (carbocaine) and 2% lignocaine.Indeed, after I learned that the curious cyanosis noted at least twice by me represented the invariable methaemoglobinaemia accompanying the use of prilo- caine' 2 I used only mepivacaine during the last months before coming to this country.I have available an impressive list of publications supporting my present conviction that mepivacaine is the best available local analgesic.It is worth noting that already eight years ago it was found that " under the (dental) conditions described carbocaine gave 82.8%,t and lignocaine 48.3% of successful anaesthesias."'Most important of all, the use of mepivacaine allows the omission of adrenaline, and this avoids the high mass- volume-time action by which adrenaline per- mits a 1°% or 2% local-analgesic concentra- tion to act, in reality, as a 6% or even higher concentration.'The grand old man of local analgesia, Professor Hans Killian, is de- servedly respected in central Europe for his opinion that most of the unpleasant effects of local analgesics are in fact due to the added adrenaline.-I am, etc.,