The Use of Oxymorphone Hydrochloride* During Anesthesia for Operations on the Head and Neck

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THIS paper is a brief report of our experience in the use of oxymorphone hydrochloride during anesthesia for surgical procedures involving the head and neck. Operations for cancer and procedures for cosmetic repair such as nasoplasty and septal reconstruction are included. No particular originality is claimed in respect to the technic described in this paper. We have found this technic to be safe for the patient and to be satisfactory to the surgeon in providing good operating conditions. It is believed that oxymorphone may well prove to be adaptable to operations involving not only the head and neck, but also other parts of the body.

The new synthetic, morphine-like alkaloid, 14-hydroxydihydromorphinone, has shown high analgesic potency on the basis of experimental and clinical investigation.1Figure 1 shows the structural relationship between oxymorphone, morphine, and dihydromorphinone. Oxymorphone differs from morphine by the replacement of an alcoholic hydroxyl group by an oxygen atom at carbon 6 position, and attachment of a hydroxyl group at the fourteenth position, and from dihydromorphinone by a hydroxyl group in the fourteenth position.2 The 7–8 bond is saturated in oxymorphone and unsaturated in morphine and dihydromorphinone.

The analgesic potency of oxymorphone in mice has been studied by Samuels, Stehlin, Dale, and Howe3 using the hot-plate method of Eddy and Limbach injecting the drug subcutaneously. Oxymorphone was found to be 15 times as active as morphine and 2.5 times as active as dihydromorphinone.

In clinical studies Eddy and Lee4 have shown that 2 mg. of oxymorphone is equivalent . . .



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