Alcohol as a Pain Killer
Ne intuearis vinum quando
flavescit cum splenduerit in vitro
color eius ingreditur blande
sed in novissimo mordebit ut
coluber et sicut regulus venena
diffundet
The Proverbs
Jerome's Latin Vulgate (405 A.D.)
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History
1668 Stirius reported the intravenous
administration of alcohol.
 1921 Nakagawa conducted experiments
with laboratory animals to study IV alcohol
combined with chloroform or diethyl ether
for induction of anesthesia.
 1929 Marin presented first comprehensive
study use IV alcohol as a general
anestetic.
 1944 Variouse clinical reports concerned
with the use of IV alcohol.
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Chemistry & Physical Properties
Colorless
 Volatil
 Hydroscopic
 Flamable
 Fluid
 Obtained by the distilation of saccharine
liquids
 Freely mix with water and chloroform
 Boils at 780C
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Pharmacokinetics
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When ingested it’s rapidly absorbed from the GI tract.
Vaporaised absorbed throug the lungs and also from
subcutaneouse sites if it’s concentration not excesive.
Complete absorbtionrate 2 – 6 hours.
Arterio venouse equlibrium established within 5 min.
Total body alcohol saturation occurs within 1 hour
Ones absorbed it’s distributed throughout all body
tissues.Oxidation begins immediately upon absorbtion and
continues as long as alcohol remains in the body.
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Pharmacodynamics
CNS more markedly affected than any
other system
 Initial stimulatory action
 Primary and continouse CNS depression
 Slowing brain activity (similar as hypoxia
and hypoglycemia)
 Does not increase mental or physical
abilities
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Cardiovascular System
 Exerts
only montor effects on the
circulation
 BP and CO remain unchanged
 Generalized vasodilatation (especialy
affects the cutaneous vessels)
 Heat loss
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Clinical Aplications
Intravenouse Analgesia
alcohol
Intravenouse Anesthesia
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Intravenouse Analgesia
Was studied in control of somatic pain
 0.9% saline infusion or 1.5 ml/kg body
weight of absolute alcohol in 10% solution
(v/v) in saline per 1 hour.
 0.75ml/kg has same effect as the 0.2 mg/kg
of morphine with same volume and
infusion rate.
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Intravenouse Anesthesia
Original method of Martin
25% alcohol solution at rate of 20 – 40 ml/min,to
reach a total dose of 2 to 3 ml/kg within 20 to 25
min.
A total dose 2.5 ml/kg induce alcohol coma
 Schenlle Infusion of 300ml of 5% alcohol was
recommended to produce a blood concentration
of 2.5 to 3.0 ml/kg after Thiopental 50 mg
itravenously
 An 8% w/v alcohol solution diluting 55 ml of
absolute alcohol (44mg) in 400 ml of Ringer
Lactate solution rapidly infused in 4 to 5 min to
total administered dose of 550 ml, if required
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Side–Effects and Complications
Occasional failure to induce sleep with the
rapid infusion (small amounts of
Barbiturate)
 “Hangover”associated with
headaches,nausea,vomiting,thirst…
(chlordiazepoxide should be given)
 Pain during within the rapid infusion of
8%w/v alcohol solution.(usually subsides
within 1 min)
 Erythrocytic lysis may occur (Hartmann’s
solution will prevent this)
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Dr. Eugene Yevstratov
ostlandfox@medscape.com
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