Practical Points in Anesthesia

Chapter 9: Vomiting During 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.

Vomiting During Anesthesia.

Vomiting

It may happen to the conscientious anesthetist, who desists from giving more of the anesthetic until he has regained his bearings, that the patient suddenly shows signs of awakening, and vomiting begins. This is a disagreeable, but generally not a serious interruption. The anesthetist is absolute master of the situation. Although the patient’s face turns somewhat blue during the vomiting efforts, the anesthetist should not attempt to push the jaw forward or exert traction on the tongue. The face is merely turned to the side and kept in position by placing the hand on the cheek. The mouth and pharynx are cleansed gently with a piece of gauze and the anesthetic is continued, drop by drop. It is often surprising in such cases how rapidly the patient can be brought back into the proper plane of anesthesia. There need be no fear that the patient will fully awake.