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Intratracheal anesthesia
New Series, VOL.I, No. 4
American Journal of Surgery
PROGRESS IN SURGERY Selections from Recent Literature INTRATRACHEAL ANESTHESIA.
Stanley Row- amenable to surgical treatment. Lobectomy
botham, EngIand. The Lancet, September I8, I926. Rowbotham concIudes: (1) IntratracheaI anesthesia is the method of choice for aII operations upon the head, nose, mouth or throat, where the anesthetist cannot maintain a satisfactory anesthesia and a free airway by the ordinary methods without seriousIy interfering with the surgeon. (2) When there is bIood in the upper air passages it is a necessity--effectiveIypreventing its entrance into the bronchi and air cells, and Iessening the IiabiIity to puImonary complications. In double or single intnbation we have a refinement which is of great heIp to the operator in shutting off the air passages and giving him a clear fieId for operating. (3) In intrathoracic operations where normaI respiratory mechanism is interfered with, double intubation enables one not only to maintain respiratory exchange, but to reguIate tile collapse"of tile lung, and so save the patient much shock.
is the onIy operation that offers the hope of permanent cure. However, in cases associated with puImonary abscess, pneumotomy with drainage of the abscess cavity is the procedure of choice. He reports a case of this sort in which pneumotomy with injection of IipiodoI directIy into the abscess cavity resulted in cure. Because of the fact that the bronchi even though diseased are covered with an epitheliaI lining, he is of the opinion that thoracoplasty and phrenicectomy act merely as does pneumothorax to diminish the size of the cavities rather to effect a cure of the condition. A LECTURE ON INJECTION-TREATMENT OF VARICOSE VEINS AND THEIR SEQUELAE (ECZEMA AND ULCUS CRURIS), CLINICALLY AND EXPERIMENTALLY. V. Meisen, Copen-
hagen.
Acta Cbirurgica Scandinavica, VoI.
LX~ Fasc. i v - v .
Tile effect of injecting strong hypertonie soIutions of salieylate of sodium (2o-5o per cent) in the veins was studied on horses. A red thrombus forms immediateIy firmly adhering THE USE OF ETHYLENE IN OBSTETRICS. A to the intima of the vessel, in the coat of which REPORT OF EIGHTY-FIVE CASES. Joseph appears filIing of the vasa vasorum, edema and Kreiselman and Howard F. Kane, Washing- bleeding in adventitia. After 24 hours the ton. Surgery, Gynecology and Obstetrics, thrombus is compressed like a wax cast and can be removed only by instruments. On the September, i926. CompIete analgesia was obtained in 84 per 6th day organization begins. In patients where a marked dilatation of the cent of cases, appreciable relief from pain in 13 femoraI saphena is found, sometimes an ascendper cent, and failure in 3 per cent. Progress during ing phIebitis of chemical nature is to be seen, the second stage of labor seemed to be more rapid. either with or without thrombus-formation. No harmful effects on the child were noted. EmboIus is never seen and this accident is not Podalic version was easily performed under Iikely to happen on account of the very firmly ethylene anesthesia. Ethylene seemed to be the adherent thrombus and t h e ambulatory ideal anesthetic for cesarean section. The efficacy of ethylene seemed to be increased by treatment. The patients shouId aIways be examined whiIe the use of morphine in the first stage. standing on a Iow tabIe or high chair in order Ethylene is vaIuable in t h e second stage of to present a good view of the functionaI condilabor because with it analgesia and anesthesia are rapidly induced; its action is fleeting; there tion of the varicose veins and their possible are apparentIy no ~'tent ilI effects on the mother connection with degenerations of the skin ) eczema or uIcer). The injection is, as a ruIe, best or child. begun at the inner side of the tibiaI condyle, BRONCHIAL DILATATION. (Dilatation bron- where several tributaries meet and the tension chique). Albert Reverdin. La Presse Mddicale, is often at its highest. The needle is introAugust 14, 1926. duced whiIe the patient is standing and some Reverdin observes that chronic bronchiec- drops of bIood are drawn to make sure that tasis is the only form of bronchiaI dilatation one is in the varix. The patient is now asked 23
American Journal of Surgery
PROGRESS IN SURGERY Selections from Recent Literature INTRATRACHEAL ANESTHESIA.
Stanley Row- amenable to surgical treatment. Lobectomy
botham, EngIand. The Lancet, September I8, I926. Rowbotham concIudes: (1) IntratracheaI anesthesia is the method of choice for aII operations upon the head, nose, mouth or throat, where the anesthetist cannot maintain a satisfactory anesthesia and a free airway by the ordinary methods without seriousIy interfering with the surgeon. (2) When there is bIood in the upper air passages it is a necessity--effectiveIypreventing its entrance into the bronchi and air cells, and Iessening the IiabiIity to puImonary complications. In double or single intnbation we have a refinement which is of great heIp to the operator in shutting off the air passages and giving him a clear fieId for operating. (3) In intrathoracic operations where normaI respiratory mechanism is interfered with, double intubation enables one not only to maintain respiratory exchange, but to reguIate tile collapse"of tile lung, and so save the patient much shock.
is the onIy operation that offers the hope of permanent cure. However, in cases associated with puImonary abscess, pneumotomy with drainage of the abscess cavity is the procedure of choice. He reports a case of this sort in which pneumotomy with injection of IipiodoI directIy into the abscess cavity resulted in cure. Because of the fact that the bronchi even though diseased are covered with an epitheliaI lining, he is of the opinion that thoracoplasty and phrenicectomy act merely as does pneumothorax to diminish the size of the cavities rather to effect a cure of the condition. A LECTURE ON INJECTION-TREATMENT OF VARICOSE VEINS AND THEIR SEQUELAE (ECZEMA AND ULCUS CRURIS), CLINICALLY AND EXPERIMENTALLY. V. Meisen, Copen-
hagen.
Acta Cbirurgica Scandinavica, VoI.
LX~ Fasc. i v - v .
Tile effect of injecting strong hypertonie soIutions of salieylate of sodium (2o-5o per cent) in the veins was studied on horses. A red thrombus forms immediateIy firmly adhering THE USE OF ETHYLENE IN OBSTETRICS. A to the intima of the vessel, in the coat of which REPORT OF EIGHTY-FIVE CASES. Joseph appears filIing of the vasa vasorum, edema and Kreiselman and Howard F. Kane, Washing- bleeding in adventitia. After 24 hours the ton. Surgery, Gynecology and Obstetrics, thrombus is compressed like a wax cast and can be removed only by instruments. On the September, i926. CompIete analgesia was obtained in 84 per 6th day organization begins. In patients where a marked dilatation of the cent of cases, appreciable relief from pain in 13 femoraI saphena is found, sometimes an ascendper cent, and failure in 3 per cent. Progress during ing phIebitis of chemical nature is to be seen, the second stage of labor seemed to be more rapid. either with or without thrombus-formation. No harmful effects on the child were noted. EmboIus is never seen and this accident is not Podalic version was easily performed under Iikely to happen on account of the very firmly ethylene anesthesia. Ethylene seemed to be the adherent thrombus and t h e ambulatory ideal anesthetic for cesarean section. The efficacy of ethylene seemed to be increased by treatment. The patients shouId aIways be examined whiIe the use of morphine in the first stage. standing on a Iow tabIe or high chair in order Ethylene is vaIuable in t h e second stage of to present a good view of the functionaI condilabor because with it analgesia and anesthesia are rapidly induced; its action is fleeting; there tion of the varicose veins and their possible are apparentIy no ~'tent ilI effects on the mother connection with degenerations of the skin ) eczema or uIcer). The injection is, as a ruIe, best or child. begun at the inner side of the tibiaI condyle, BRONCHIAL DILATATION. (Dilatation bron- where several tributaries meet and the tension chique). Albert Reverdin. La Presse Mddicale, is often at its highest. The needle is introAugust 14, 1926. duced whiIe the patient is standing and some Reverdin observes that chronic bronchiec- drops of bIood are drawn to make sure that tasis is the only form of bronchiaI dilatation one is in the varix. The patient is now asked 23