Practical Points in Anesthesia

Chapter 14: General Course of the Anesthesia.

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About This Book

Practical techniques for inducing and maintaining inhalation anesthesia with chloroform, ether, and anaesthol are presented, including mask configuration and gradual dropwise induction. Cautious administration and morphine premedication are recommended, with respiratory patterns and reflexes used to judge the surgical plane. Recognition and management of complications—cardiac and respiratory collapse, obstructed breathing from crowding, and reflex responses to surgical manipulation—are discussed. Airway measures such as breathing tubes, intubation, jaw and tongue maneuvers, oxygen, and artificial respiration are outlined. Advice on maintaining depth, when to stimulate, sequencing agents for different procedures, awakening, and postoperative distress completes the practical guidance.

General Course of the Anesthesia.

Tranquil Narcosis

The ideal narcosis is tranquil. It resembles a natural sleep. The breathing is unimpeded and easy. Any change in the character of the breathing sound, or the rhythm, demands attention. If, for the moment, the anesthetic has been given too hurriedly, a few breaths of air will restore the calm. If, on the other hand, signs of awakening are discovered—the lid becomes more tonic, the corneal reflex more active, a tear appears in the eye, the patient begins to sweat, saliva collects in the throat, the pulse becomes more rapid—a few drops of the anesthetic should be administered until the desired free and unembarrassed respiration returns.