J.Jpn. Surg. Soc.. 55(1): 1-10, 1954

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Original article

EXPERIMENTAL AND CLINICAL STUDIES OF THE RECTAL ANESTHESIA BY N-METHYL-CYCLOHEXENYL-METHYLBARBITAL-SODIUM

The rectal anesthesia has the following advantages : a simple technic of administration, no offensive odour, no presence of excitement stage, a long duration of anesthesia, and no complication of lung. Therefore, we feel actually the need of the rectal anesthesia for basal narcosis to younger people and children.
As we couldn't get "Avertin" or "Brotatin"- Japanese made-I studied the rectal anesthesia by the use of "Cyclopan Sodium'' and "Ouropan Sodium" which we could get easily and by cheaper price.
I have memoried the history of the rectal anesthesia, and tried experimental and clinical studies about it.
For deciding lethal dose of agents such as Evipal Sodium, Cyclopan Sodium, and Ouropan Sodium, I injected 1% solution subcutaneously on the back region of mouse, and I got the same effect of narcosis at around 0.28 gm per kg. body weight. And then administering 1% Cyclopan Sodium rectally by the use of rabbit and observing the depth of Anesthesia by Gyrundt's methode, I couldn't get the sixth narcotic degree when the amount of this agent was 0.03 gm per kg. body weight the duration of the sixth narcotic degree prolonged gradually. The rabbit died for 0.1 gm per kg. body weight. I explained that the duration of action by using per rectum was longer than intravenously.
When I observed anesthetized rabbits by barbiturate which was administered rectally, breathing became slowly and deeply, and recovered with disappearance of action.
During anesthesia, we must be careful of shallow anesthesia. Blood pressure and pulse rate will change slightly in adequate dose. Electrocardiogram of anesthetized rabbits by 1 % Cyclopan solution per rectum didn't indicate no disturbance or indicated slight change such as transient myocard disturbance.
I want to mention the procedure and progress which can be applied for clinical purpose I administer an enema for patient before operation, and put in the catheter about 15cm deeply in the anus, and apply rectaly from 0.03 gm to 0.05 gm. per kg. body weight of 1% solution of Cyclopan Sodium in volume, but the adequate volume is 0,04 gm per kg. body weight commonly.
When this initial dose proves insufficent, after twenty minutes 0.1 gm is added.
Doing so, within from 10 minutes to 15 minutes, patients fall into deep anesthesia such as natural sleep, and after about 5 hours awake.
The time inducing to deep anesthesia is influenced by administration of morphine, and surroundings, etc.: and generally large dose is rapid in action.
There is little change in blood pressure.
Pulse rate increase, but tension is good.
Respiration is regular and relatively deep, but its rate tends to increase. Disadvantages in this rectal narcosis are as followings: cramp in the legs and arms, excitement in awakening, and respiratory tract obstruction which is due to mucus secretions and prevented by injection of atropine sulphate. I observed 71 clinical cases of rectal anesthesia of Cyclopan and Ouropan sodium, and I knew this methode was able to be applied clinically and get satisfactory narcosis. (author's abstract).

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