Practical Points in AnesthesiaNeef, Frederick-Emil
Science
Practical Points in Anesthesia
Neef, Frederick-Emil
Anesthetics
The extensive use of ether and the experience that its incautious
administration is fraught with but little immediate danger, has gotten
the hospital interne into reckless habits which cling to him in
practice. There the anesthetist finds himself frequently compelled to
use chloroform, a narcotic many times more powerful than ether. In the
hands of the inexperienced, and above all, the inattentive, chloroform
is certainly a dangerous drug. But this does not detract from its great
value as an anesthetic and it would be illogical to condemn its use.
In the aged, we know that it is not so much the operation itself as
the broncho-pneumonia that often follows the anesthesia which deserves
grave consideration. Chloroform, or a chloroform-ether combination,
such as anaesthol, is undoubtedly, in such cases, preferable to pure
ether, because it causes less bronchial irritation. In the
morphine-anaesthol-ether sequence which I have tried to outline,
chloroform and ether are blended in a way most adequate for
anesthesia, and the system is so flexible that it readily adapts
itself to an anomalous case.
The difficulties in respiration so frequently encountered, even by the
experienced anesthetist, find a natural solution; if he has been
studying the case he will be able to judge whether the trouble is due to
crowding or to a mechanical cause.
I have no hopeful word for the anesthetist who is inattentive. Whether
the case is an apparently simple or a critical one, it should be
remembered that the good anesthetist, like the good surgeon, is he who,
besides being competent, has a conscience, and feels his responsibility,
who appreciates _that there are some who are anxiously awaiting the
outcome, and have a deep interest in the life that is in his hands_.
INDEX
Anaesthol, 36
Anesthesia, Complete, 11
Depth Required by Various Cases, 43
General Course of, 31
Induction of, 10
Intubation, 39
Minor, with Ethyl-Chloride, 38
Primary, 11
Anesthetic, Concentrated, 24
Ano-respiratory Reflex, 22
Asphyxia, Post-operative, 33
Awakening, Signs of, 16, 31
Stimuli, 16
Breath, Holding the, 22
Breathing, Influence of Morphine on, 37
Mechanical Obstruction to, 25
Obstructed, 24
Breathing-tube, 26
Camphor-Ether Stimulation, 29
Cardiac Collapse, 12
Cases Requiring Superficial Anesthesia, 43
Deep Anesthesia, 44
Clogging of the Anesthesia Tubes, 42
Cocainization of the Pharynx, 40
Collapse, Cardiac, 12
Respiratory, 14
Color, 17
In Intubation Anesthesia, 42
Complete Anesthesia, 11
Cornea, 19
Coughing During Narcosis, 22
Crowding, 13, 24
Degree, Surgical, 11
In Intubation Anesthesia, 41
Distress, Post Operative, 34
Ethyl-Chloride, Minor Anesthesia with, 38
Eyelid Test, 20
Gas Pain, 34
Holding the Breath, 22
Idiosyncrasy, Individual, 21
Incision, Initial, 15
Individual Idiosyncrasy, 21
Induction of Anesthesia, 10
Infusion, Venous, 29
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