Caudal block with xylocaine.

block with Xylocaine (w-diethylamino-2-6-V_>dimethylacetanilide) has been used for a number of lower abdominal operations during the last few months, and whilst the number is far too small for any real assessment of its value, the results so far have been so remarkably successful that it was thought worth while to draw attention to this use of the drug in this preliminary communication. The disadvantages of caudal block in the past have been, in the author's opinion, the uncertainty of the effect and the delay taken for the analgesia to come on. This, with procaine or amethocaine, was in the order of 20 minutes to half-an-hour. With 2 per cent Xylocaine the following order of times has been found to be usual, but there is considerable variation: Perineal analgesia — 2 minutes after injection. Analgesia to the umbilicus — 5 minutes after injection. To begin with, some of the local analgesic solution was injected under the skin of the lower abdomen after the block was given in order that the surgeon might start the operation at once, but it was very soon found that unless the patient was turned over and prepared very rapidly, the injections were being made into an already analgesic area. The following operations have been performed under caudal analgesia with Xylocaine: Retropubic, intravesical and transurethral prostatec-tomy—17 cases. Intravesical removal of papilloma of bladder—1 case.