A Precaution in the Use of Procaine-Epinephrine for Regional Anesthesia

To the Editor: —With the extensive amount of surgical work now done under local anesthesia, it is surprising to note how few instances of untoward effects are recorded in medical literature. This is probably due to the care exercised in the preparation of the solutions, such care being the result of the mishaps with the treacherous cocaine formerly used for injection. It was, however, inevitable that, with the modern tendency to speed up everything, time and labor saving devices would invade the field of peripheral anesthesia, and so ampules and carpules of procaine and epinephrine mixtures ready for immediate use were introduced. These were not objectionable so long as the strength and proportions of the drugs were within the bounds recommended by the specialists in regional anesthesia. In fact, they are a boon for office use in minor surgery. When one considers the thousands of injections of procaine-epinephrine that are