J. T. Russell
Jan 1, 1969
Citations
0
Influential Citations
3
Citations
Journal
Anaesthesia
Abstract
Cyclizine, used as the hydrochloride or the lactate, is one of the most useful and safest drugs used in anaesthesia. In medicine generally, it is used as an antiemetic as much, if not more, than practically any other drug. In the 5Omg tablet form (Marzine), it is in many a pocket and handbag for the palliation of motion sickness. The 50mg ampoule must be injected thousands of times daily. Basically the drug is an antihistamine antiemetic and although less effective in this regard than a number of the phenothiazines, it causes fewer side effects, especially in prolonged usage. Unlike the phenothiazines it does not appear to cause liver dyscrasias, jaundice, agranulocytosis, extrapyramidal symptoms or dystonia. In fact its only toxic effects are listed as drowsiness, dryness of the mouth and blurred vision’-4. For some time in this area cyclizine has been used prophylactically to counter post-operative nausea and vomiting. N o dangerous side-effects have ever been noted. Apparently no serious toxic effects have been reporteds. Since the introduction of propanidid as an induction agent6~7~8, this drug has been used extensively. In this country-and particuiarly in this area (Eastern Cape)the drug has been found to be of great value, not only because it has a short duration of action99 I 0, but also because it appears to have no deleterious effects on the porphyric patients prevalent here 1 1 ’ 1 2 . The disadvantages of cardiovascular depression1 3.14, the increased incidence of nausea’ and the prolonging of the action of suxamethonium6, do not detract from the value of the drug as an induction agent, particularly in outpatients1 5 . In fact, propanidid may be, in some instances, safer than the barbiturates as its quinidine-like action on the cardiac conductive tissue produces a protective anti-arrhythmic action on the heart 16. No reports of anaphylactic reactions to the drug have appeared] 7. Because of the increased incidence of post-operative nausea and vomiting associated with the usage of propanidid, it became customary to administer 50mg of cyclizine intramuscularly during the operation. Unfortunately a considerable number of patients complained of pain a t the