A STUDY OF PENTOTHAL SODIUM ANESTHESIA AND A CRITICAL INVESTIGATION OF THE USE OF SUCCINATE AS AN ANTIDOTE

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Abstract
In man the barbiturates inhibit cellular glucose metabolism, but not succinic acid metabolism. It was assumed that large amts. of intraven. succinate might serve as a source of energy for the brain when glucose metabolism has been inhibited by barbiturates. Data are presented covering 3 yrs. of exptl. work on two large groups of normal individuals and psychiatric patients. Electroencephalograms (Walter''s technique) on resting patients were correlated with those following intraven. pentothal anesthesia of varying depths. Subsequently, intraven. Na2 succinate soln. (concn. 30%, 15-36 g. in 9-45 min.) was administered before, during and following pentothal anesthesias. An adequate control series was run with NaHCO3 and Na lactate to rule out Na ion effect on the eeg''s. and signs of narcosis. Individual case reports illustrate the wide range of equivocal results and indicate that a definite decision as to the value of succinate is unjustifiable at present. In assessing the antidotal effects of Na2 succinate, caution is stressed concerning the development of tolerance to pentothal administered on successive days. The admn. of succinate to children, tracheotomized patients, the debilitated and elderly patients is not recommended due to transient side -effects in 30-50% of cases,ie., mild choking, thickened voice, neck and face flush, edema and brawniness of the skin.

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