Tetanus: conservative management made easier by combination of muscle relaxants

Conservative management of 11 consecutive cases of tetanus with diazepam in heavy doses and methocarbamol is described. All drugs were administered intravenously through a cut-down. Patients were nursed near the nurses' station for the first 3 to 5 days when fatal complications and very severe spasms are most likely to occur. There was minimal interference with the patients and a reasonable reduction in the duration of significant spasms, and complications were minimized. No neonates were included. Severity of tetanus cannot be determined only by consideration of onset of symptoms before admission. It is suggested that a combination of muscle relaxants without heavy sedation may produce an improvement in the results of conservative management of clinical tetanus.