Handbook of anæstheticsRoss, J. Stuart (John Stuart)
Science
Handbook of anæsthetics
Ross, J. Stuart (John Stuart)
Anesthesia; Anesthetics
It is wise, particularly in one’s early days, to give a trace of ether
vapour during the latter part of the induction stage, and to maintain
it until the operation is well under way. Once the anæsthetist is
satisfied that the narcosis is proving deep enough for the purposes
of the operation, the ether may be shut off and will probably not be
required again.
Remember that _depth_ of anæsthesia can be secured in three ways--(1)
cutting down the oxygen percentage; (2) increasing the tension of
the mixed gases; (3) adding a little ether. Of these, No. 1 is most
undesirable, and if carried to the least excess over a period of more
than a minute or two may lead to an accident. No. 3 is the means for
the beginner to rely upon, until he learns the judicious and skilful
use of No 2. The anæsthetist who is learning the method of anæsthesing
must resolve that nothing shall tempt him to overstep the stage of dull
pink colour, and moderate pupils. If with gas-oxygen alone, he cannot
get a satisfactory anæsthesia without resorting to oxygen starvation,
let him not be ashamed to turn on his ether.
Abdominal relaxation sufficiently complete to permit the surgeon to
explore the abdominal cavity with ease, is not readily secured by
gas-oxygen in a patient of robust type. Fortunately, it is the weakly
or the severely shocked who really _need_ this form of anæsthesia, and
in them abdominal relaxation is fairly easily obtained.
Professor Crile, as has already been explained, does not rely upon
the inhalational anæsthetic alone. He infiltrates each layer of the
parietes with novocain, thus producing a local anæsthesia. If this
method be faithfully carried out by the surgeon, a most complete
relaxation of the muscles can be secured.
CHAPTER IX.
ETHER.
The drug commonly known as ether and otherwise described as ethylic
ether or sulphuric ether, has a chemical formula (C_{2}H_{5})_{2}O.
It is a transparent colourless fluid with a specific gravity of ·720
to ·723. A brand much used in the States has an S.G. of ·713 only, a
point which is greatly emphasised by its supporters, who claim that it
volatises quicker and therefore is more powerful in action. The author
has in actual practise not found much difference between this brand and
any good British one.
Ether is highly inflammable and volatilises readily at ordinary
room temperatures. Its boiling point is 96° to 98° Fahr. Whether
evaporating from a fabric such as gauze, or from bulk in a jar, ether
cools very rapidly, and the fall in temperature soon reduces the
ease of its volatisation. This point is of some practical importance
in anæsthetics, and some years ago the author made a number of
observations, hitherto unpublished, with a view of ascertaining some
definite facts in this connection. His results will be found in
Appendix I.
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