Practical Points in AnesthesiaNeef, Frederick-Emil
Science
Practical Points in Anesthesia
Neef, Frederick-Emil
Anesthetics
In the German Hospital system the patient, male or female, is given a
quarter of a grain of morphine sulphate hypodermatically half an hour
before narcosis. The anesthesia is always induced with anaesthol or
chloroform. _Where much blood is lost or the operation is of very long
duration one may at any time make the transition to ether by the drop
method without changing the mask._ As a rule, a morphine-anaesthol
narcosis is given with a few drops of ether now and then (ether
feeding), when a little stimulation is indicated. In a small number of
cases, among them choledochotomies and other operations on the
gall-bladder, particularly where there is jaundice, the
morphine-anaesthol introduction is followed by the ether drop method.
CARDIAC COLLAPSE.
Cardiac collapse is fortunately uncommon. It usually occurs during the
induction of anesthesia. Suddenly there is a marked pallor of the face
and the pulse becomes weak. It happens in chloroform, and occasionally
in anaesthol narcosis. When such a tendency is discovered _ether_ should
be given by the drop method.
_Gradual induction_ of anesthesia until the patient’s tolerance to
chloroform is ascertained, is of cardinal importance.
RESPIRATORY COLLAPSE.
Obstructed breathing developing during the induction of narcosis is apt
to be due to _crowding_. If obstructed breathing becomes manifest later,
that is, during the course of the operation, it may be due to
_inhibitory reflex elicited by the surgeon_. Traction on the gall
bladder or mesentery will sometimes evoke a peculiar noisy breathing
which does _not_ mean that the patient is insufficiently under the
influence of the anesthetic. The breathing becomes normal and
unrestrained as soon as the surgeon desists from these vigorous
manipulations.
[Sidenote: Crowding]
[Sidenote: Respiratory Collapse]
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account