Canadian Journal of Anesthesia, Vol 2, 14-22, Copyright © 1955 by Canadian Anesthesiologists' Society

Clinical Impressions on the Use of Largactil at Shaughnessy Hospital

¹ Anaesthetist, Shaughnessy Hospital, Department of Veterans Affairs, Vancouver, B.C.

Largactil has been used in Shaughnessy Hospital in a total of 330 cases. The drug was used intravenously during surgery, and orally and intramuscularly in conjunction with usual premedication. In general the intramuscular route was felt to be the most satisfactory.

Although Largactil did appear to have some advantages—such as reducing the amounts of anaesthetic agents required and promoting smooth operative and postoperative courses in the aged—it was felt that its disadvantages outweigh the advantages. These disadvantages may be listed as follows.

1. The drug is irritant to tissue.

2. A profound adrenergic blockade is sometimes produced with associated marked drop in blood pressure.

3 The awakening period was prolonged.

4. The greatest disadvantage of Largactil was judged to be its unpredictability.

A technique suggested by Baxter, Bolster, and McKecknie was described where three phenothiazine derivatives, Largactil, Diparcol, and Phenergan, were combined. Although only fifteen cases were reported, the patients required such small amounts of supplementary anaesthetic agents during the operation, and made such excellent postoperative recovery, that further investigation of this technique was considered important.

In conclusion I would like to give credit to Dr. W. M Hall, Dr. D. E. Mackay, and Dr. E. Ritch whose help in the preparation of this paper was invaluable.

Note:

Presented at the Annual Meeting, Canadian Anaesthetists' Society, Vancouver, British Columbia, June 14–15, 1954.