Pain Control Following Upper Abdominal Operations

PULMONARY complications may follow any type of surgery. Pooler1has studied 5,869 surgical patients and found the occurrence of pulmonary morbidity following extra-abdominal, lower abdominal and upper abdominal operations to be 1 per cent, 11 per cent and 19 per cent, respectively. It is apparent, therefore, that every possible precaution should be employed to prevent these complications in patients who have undergone operations in the upper region of the abdomen. This is particularly true in poor risk patients, patients with pulmonary disease, the aged, and the emotionally unstable who are actual or potential narcotic addicts. Pain diminishes respiratory excursions; there is a reluctance to cough or breathe deeply. Narcotics will relieve pain but will inhibit the important cough reflexes. Pooler1has attempted to prevent pulmonary complications following operations by the use of intravenous injections of procaine hydrochloride. After administration of the drug he encouraged his patients to cough