The question of anaesthesia in goitre operations / by William Seaman Bainbridge.

  • Bainbridge, William Seaman, 1870-1947.
Date:
1913
Catalogue details

Licence: In copyright

Credit: The question of anaesthesia in goitre operations / by William Seaman Bainbridge. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    there is a tendency to exaggerate the dangers of genera] narcosis in goitre operations will undoubtedly diminish on the basis of increasing practical evidence. It is certainly suggestive that authorities such as Kocher, Rehn, Socin, Jaboulay, and others, unconditionally oppose general nar- cosis in these cases. Their operative records bear eloquent testimony to the soundness of their views. If, for any reason, general anaesthesia must be em- ployed, the essence of orange-ether proposed by Gwathmey, or any other vapor anaesthesia, is the most satisfactory. Vapor anaesthesia, with the apparatus first proposed by Gwathmey, in 1910, provides for the giving of a smaller amount of the anaesthetic than is required with any other method. Excitement is usually absent or inconsiderable, and unpleasant after-effects are altogether absent in ninety per cent, of the cases. All patients can be narcotized within five minutes, and a satisfactory continued narcosis is always maintained. The addition of one to three drops of the oil of orange, or three to five drops of the essence of orange (25 per cent, oil of orange and 75 per cent, deodor- ized alcohol) serves to disguise the odor of the anaesthetic very efficiently, in this way diminishing the undesirable side effects incident to the inhalation of the gas, and ap- proaching this method to the principle of Crile’s anoci asso- ciation. Anoci Association. The anoci association of Crile intro- duces new features into the aspect of anaesthesia, by taking into consideration the psychic side of the patient. The method consists in the injection of local anaesthetics into the field of operation, in addition to the other preparations, prior to the giving of the general anaesthetic. The proced- ure is based upon the observation that the psychic excite- ment of the goitre bearer is one of the greatest obstacles in the way of operative success. Observation of Crile’s work is most interesting and cannot fail to impress the spectator with the desirability of utilizing the elements of anoci asso- ciation in the operations under consideration. Crile claimed and showed that the general anaesthesia, more particularly with ether, fails to protect the brain cells against exhaus- tion from the operative traumatism. The shock incident to