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Canadian Journal of Anesthesia, Vol 3, 291-315, Copyright © 1956 by Canadian Anesthesiologists' Society

Evaluation of "Dolitrone"

GORDON M. WYANT F.F.A.R.C.S.1, CHRISTOPHER J. KILDUFF M.B., B.CH.1, JOHN E. MERRIMAN M.D.1, and ALLEN B. DOBKIN M.D.1

1 Departments of Anaesthesia and Medicine (Cardio-pulmonary Service) University of Saskatchewan College of Medicine & University Hospital, Saskatoon

Dolitrone, a non-barbiturate intravenous anaesthetic agent, has been compared to sodium thiopental m human volunteers. The drug has also been administered to a series of patients undergoing minor surgical procedures. In these clinical cases the drug has been evaluated both as an induction and as a maintenance agent. In a further study the analgesic properties of Dolitrone were assessed.

From these, it would appear that Dolitrone has three principle desirable properties

1 Because of its marked respiration sparing properties, it could be a useful induction agent. It causes practically no apnoea in double the sleep dose and no significant hypotension. No cardiac irregularities were noted.

2 Muscle relaxation for such procedures as pelvic examinations under anaesthesia is often satisfactory but unpredictable.

3. Dolitrone has definite analgesic properties although the state of analgesia is subjectively less pleasant than that induced with nitrous oxide, trichlorethylene, or intravenous procaine. It is reasonable to assume that a more profound state of analgesia may be obtained if suitable premedication is given.

We have been unable to demonstrate any amnesic properties of the drug.

Against these three advantages are set three overwhelming disadvantages of the agent:

1 The high incidence of phlebitis, which ranges from mild to very severe, precludes the use of Dolitrone for anaesthesia or analgesia al the present time, except as a single injection for induction of anaesthesia when phlebitis does not seem to be common. However, one must ask. "Is there a need for another intravenous agent when it must be strictly limited to induction alone?". The incidence of phlebitis could probably be reduced if injection were made into the tubing of a running saline infusion. Unfortunately this would entail the administration of undesirably large amounts of normal saline and is therefore not practicable. 5 per cent Dextrose solution which could lbe given in larger quantities is unfortunately not compatible With the drug.

2 The unpredictability of Dolitrone as'a maintenance agent and as far as relaxation is concerned is a serious disadvantage.

3 The frequent occurrence of spontaneous and often uncontrollable movements despite large doses render the agent unsuitable for maintenance of anaesthesia.

The drug was so unsatisfactory in clinical use that it was discontinued in each group after it had been used in a relatively small number of cases.

In conclusion, after weighing the advantages and disadvantages of Dolitrone we do not feel that at the present time it can be recommended as a desirable clinical agent. The analgesic properties of Dolitrone are intriguing; whether or not they can be utilized clinically will depend upon the ability of the chemists to evolve a compound less likely to cause venous irritation.

Note:

Presented at the Annual Meeting, Canadian Anaesthetists' Society, at Mont Tremblant, P Q, June 18, 1956.






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Copyright © 1956 by the Canadian Anesthesiologists' Society.