Pruritus in burns. Comments from the Vancouver General Hospital Burn Unit, Vancouver, British Columbia.
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After application of alimemazine (1) 14 phenothiazine derivatives were detected in the rat urine. The structure of 9 metabolites was elucidated (TLC detection, UV, MS), which are hydroxy, N-dealkyl, S-oxide, and sulfone derivatives of 1. The hydroxy compounds, which are the main metabolites (greater than 50%), are partly conjugated. 5-10% of sulfones were observed. Some of the metabolites were detected in the feces, too. The relationship of the excretion products in urine and feces is 75:25%.
Continuous ECG recording (Holter technique) was carried out in 25 patients undergoing similar ophtalmological surgery for retinal detachment. The patients were selected at random and divided into two groups. Premedication (alimemazine 25 mg. atropine 0.5 mg given one hour before the operation) and induction (penthiobarbital 4 mg.kg-1 and succinylcholine iodide 1 mg.kg-1) were given in the same way. General anaesthesia was maintained in Group I (n = 12) with halothane and in group II (n = 13) using neuroleptanalgesia. There was no significant difference in the percentage of arrhythmias between the two groups. There was a remarkablly high prevalence of sinus bradycardia and ventricular pauses (8/25). The respective role of atropine and of retrobulbar local anaesthesia in prevention is discussed in the light of data from the literature. If arrhythmias occurring at the time of intubation are included, the total percentage of rhythm disturbances was 80 p. 100 (20/25).
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