Handbook of anæstheticsRoss, J. Stuart (John Stuart)
Science
Handbook of anæsthetics
Ross, J. Stuart (John Stuart)
Anesthesia; Anesthetics
The amount of vomiting which after this stage may be regarded as
normal is difficult to determine. The author took notes of some 300
cases on this point. The details of his results are not suitable for
a text book, but, broadly speaking, it would appear that after an
operation of ordinary duration and severity, the vomiting returns on
the average some five or six times, and usually ceases on the evening
of the operation day. A limited number continue to vomit at intervals
until the early hours of the following morning. With nitrous oxide
and oxygen the vomiting is far less than the above, though even with
this anæsthetic quite severe emesis may occur. With closed-ether, the
trouble is very violent for a short time, large quantities of mucous
being ejected: it is probable that after the first two hours, it is no
more marked than after open methods. The use of morphia and atropine
before operation most certainly reduces the violence and duration of
this sequela.
Prolonged more than twenty-four hours, the condition must be regarded
as definitely abnormal.
PREVENTION AND TREATMENT.
The adoption of open-ether preceded by morphia and atropine and due
skill and thought on the part of the anæsthetist, combined with proper
preparation of the patient, are the only means of prevention at our
command.
The raised position of the head and shoulders during the recovery
stage undoubtedly tends to reduce the nuisance. It is a vexed question
whether to give or to withhold fluids after operation--and this matter
is of course in the hands of the surgeon, not the anæsthetist. In
certain cases, the author believes that it is worth while trying the
effect of a cup of fresh tea with very little sugar or milk. Even if
rejected in a few moments, the astringent effect of the infusion seems
to soothe the gastric mucous membrane, and give relief.
Post-operative Acidosis.
(Synonym--Delayed Chloroform Poisoning).
In a limited number of cases, post-operative emesis assumes a grave
type, and definitely threatens life. Such cases began to be studied
in the early part of this century, and though our knowledge of the
condition is still incomplete, the student should be acquainted with
the present views held upon the subject.
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