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LIVERPOOL SOCIETY OF ANAESTHETISTS
SOCIETY NEWS
LIVERPOOL SOCIETY OF ANAESTHETISTS of the Liverpool Regional Hospital Board, and Mrs. Keeling; Dr. Lloyd Hughes, Chief Medical Officer, Liverpool Regional Hospital Board, and Mrs. Lloyd Hughes; Mr. A. Charles King; Dr. Hunter, President of the Anaesthetic Section, The Manchester Medical Society, and Mrs. Hunter; and Mr. W. Lee, The Librarian of the Liverpool Medical Institution, and Mrs. Lee. The toast " The Liverpool Society of Anaesthetists" was proposed by Sir Arthur Gemmell, and the President, Dr. R. J. Minnitt, replied. Dr. J. B. Hargreaves proposed the toast " Our Guests ", to which Sir Henry Cohen replied. During the evening, one of the guests, Mr. Stephen Wearing, rendered pianoforte solos to the great enjoyment of those present. The proceedings terminated by the singing of Auld Lang Syne and the National Anthem.
Downloaded from http://bja.oxfordjournals.org/ at Harvard University on July 10, 2015
A DINNER was held at the University Club, Mount Pleasant, Liverpool, on Saturday July 16, 1955, to celebrate the twenty-fifth anniversary of the formation of the Society. The seventy-two members and guests were received by Dr. R. J. Minnitt (the President) and Mrs. Minnitt. Among the guests present were Sir Arthur Gemmell, President of the Royal College of Obstetricians and Gynaecologists Sir Henry Cohen, Professor of Medicine, The University of Liverpool, President of the Liverpool Medical Institution; Dr. Frankis Evans, Dean of the Faculty of Anaesthetists of the Royal College of Surgeons, and Mrs. Frankis Evans; Professor Charles Wells, Professor of Surgery, the University of Liverpool, and Mrs. Wells; Mr. J. Leggate, Dean of the Faculty of Medicine, The University of Liverpool, and Mrs. Leggate; Mr. Keeling, Chairman of the Board of Governors, The United Liverpool Hospitals and
CORRESPONDENCE A CASE FOR ENDOBRONCHIAL ANAESTHESIA one lubricated the outside of the bronchoscope Sir,—To those of us who are rarely con- with some petroleum, it would fit the inside of fronted with the problem of anaesthesia for lung the No. 8. portex tube snugly enough so that they operations where the patient is exhibiting large would not move one upon the other during amounts of secretions from the diseased lung, the bronchoscope manipulation and yet at the same purchase of something like a Carlens tube seems time it was easy to slide the bronchoscope out to be a needless extravagance. In this country once the tube was properly positioned. Thus such a tube costs around 45 dollars, and such an using a cuffed portex tube and the Jacksonscope item might very well lie around in a drawer and we were able to place the tube well into the main rot before we might get to use it, to say nothing stem bronchus on the left under topical anaesthesia of the problem of using it properly when the and after inflating the cuff we had a perfect fit. For occasion would demand it. the first time in months the patient breathed freely for about an hour and a half while the We recendy were confronted with the problem of a patient who had enormous amounts of secre- surgeons opened a huge abscess in the liver which tions in his respiratory tract, and who required communicated with a similar one in the right an emergency operation for which general anaes- lower lung through a large opening in the thesia was deemed necessary. We got by so well diaphragm. At the end the tube was slowly withthat we thought- your readers might be interested drawn as constant suction was being applied with a suction catheter. in how this was handled. The patient was a 45-year-old white male who It need hardly be pointed out that we were for several months had been a diagnostic enigma unaccountably lucky to have the left lung available to both the medical and surgical departments until to us. We could not have done the same thing one day he solved the riddle by proceeding to on the right without occluding the right upper cough up huge quantities of bile-stained material. lobe bronchus. For those anaesthetists, however, It took very little imagination or doing thereupon who are fortunate enough to have patients who to prove that what he had started with was an are considerate enough to allow them to use the abscess in the liver and that this had succeeded in left lung for anaesthesia we can recommend this rupturing through the diaphragm into the chest technique very highly. to find an outlet via the right lower lobe bronchus. SEYMOUR SCHOTZ, By the time he was presented to us this patient Philadelphia, U.S.A. had been coughing up in excess of 20 ounces of bile-stained material daily. This would come up APNOEA ON CESSATION OF CONTROLLED in amounts up to an ounce at a time. He had RESPIRATION been running a septic fever in spite of all manner of antibiotics, his weight had shrunk to a mere Sir,—In the June issue of the Journal, Dr. 85 pounds, and his pulse rate hovered around 140 Wylie discussed the possible causes of persistent per minute. The proposed operation was an apnoea after prolonged controlled respiration. exploration of the liver for an abscess, the surgical I found Dr. Wylie's explanations most interapproach being through the bed of the 12th rib esting, but it appeared to me that for the most with the patient in the lateral position right side part they dealt with persistent apnoea following up. It was felt that a general anaesthesia would be an overdose, absolute or relative, of anaesthetic needed for an adequate exploration. An endo- agents or muscle relaxants. Manual ventilation bronchial technique seemed the only answer to for apnoea due to these causes, to my mind, should general anaesthesia sine inundation. be referred to as " artificial" rather than conHaving no special endobronchial tubes or trolled respiration. I believe that the term " conblockers, we fashioned an endobronchial technique trolled respiration " should be reserved for that out of a regular 5/40 Jackson bronchoscope and type of respiration in which voluntary respiratory a No. 8 portex Magill tube. It was found that if movement has been abolished but where spon513
LIVERPOOL SOCIETY OF ANAESTHETISTS of the Liverpool Regional Hospital Board, and Mrs. Keeling; Dr. Lloyd Hughes, Chief Medical Officer, Liverpool Regional Hospital Board, and Mrs. Lloyd Hughes; Mr. A. Charles King; Dr. Hunter, President of the Anaesthetic Section, The Manchester Medical Society, and Mrs. Hunter; and Mr. W. Lee, The Librarian of the Liverpool Medical Institution, and Mrs. Lee. The toast " The Liverpool Society of Anaesthetists" was proposed by Sir Arthur Gemmell, and the President, Dr. R. J. Minnitt, replied. Dr. J. B. Hargreaves proposed the toast " Our Guests ", to which Sir Henry Cohen replied. During the evening, one of the guests, Mr. Stephen Wearing, rendered pianoforte solos to the great enjoyment of those present. The proceedings terminated by the singing of Auld Lang Syne and the National Anthem.
Downloaded from http://bja.oxfordjournals.org/ at Harvard University on July 10, 2015
A DINNER was held at the University Club, Mount Pleasant, Liverpool, on Saturday July 16, 1955, to celebrate the twenty-fifth anniversary of the formation of the Society. The seventy-two members and guests were received by Dr. R. J. Minnitt (the President) and Mrs. Minnitt. Among the guests present were Sir Arthur Gemmell, President of the Royal College of Obstetricians and Gynaecologists Sir Henry Cohen, Professor of Medicine, The University of Liverpool, President of the Liverpool Medical Institution; Dr. Frankis Evans, Dean of the Faculty of Anaesthetists of the Royal College of Surgeons, and Mrs. Frankis Evans; Professor Charles Wells, Professor of Surgery, the University of Liverpool, and Mrs. Wells; Mr. J. Leggate, Dean of the Faculty of Medicine, The University of Liverpool, and Mrs. Leggate; Mr. Keeling, Chairman of the Board of Governors, The United Liverpool Hospitals and
CORRESPONDENCE A CASE FOR ENDOBRONCHIAL ANAESTHESIA one lubricated the outside of the bronchoscope Sir,—To those of us who are rarely con- with some petroleum, it would fit the inside of fronted with the problem of anaesthesia for lung the No. 8. portex tube snugly enough so that they operations where the patient is exhibiting large would not move one upon the other during amounts of secretions from the diseased lung, the bronchoscope manipulation and yet at the same purchase of something like a Carlens tube seems time it was easy to slide the bronchoscope out to be a needless extravagance. In this country once the tube was properly positioned. Thus such a tube costs around 45 dollars, and such an using a cuffed portex tube and the Jacksonscope item might very well lie around in a drawer and we were able to place the tube well into the main rot before we might get to use it, to say nothing stem bronchus on the left under topical anaesthesia of the problem of using it properly when the and after inflating the cuff we had a perfect fit. For occasion would demand it. the first time in months the patient breathed freely for about an hour and a half while the We recendy were confronted with the problem of a patient who had enormous amounts of secre- surgeons opened a huge abscess in the liver which tions in his respiratory tract, and who required communicated with a similar one in the right an emergency operation for which general anaes- lower lung through a large opening in the thesia was deemed necessary. We got by so well diaphragm. At the end the tube was slowly withthat we thought- your readers might be interested drawn as constant suction was being applied with a suction catheter. in how this was handled. The patient was a 45-year-old white male who It need hardly be pointed out that we were for several months had been a diagnostic enigma unaccountably lucky to have the left lung available to both the medical and surgical departments until to us. We could not have done the same thing one day he solved the riddle by proceeding to on the right without occluding the right upper cough up huge quantities of bile-stained material. lobe bronchus. For those anaesthetists, however, It took very little imagination or doing thereupon who are fortunate enough to have patients who to prove that what he had started with was an are considerate enough to allow them to use the abscess in the liver and that this had succeeded in left lung for anaesthesia we can recommend this rupturing through the diaphragm into the chest technique very highly. to find an outlet via the right lower lobe bronchus. SEYMOUR SCHOTZ, By the time he was presented to us this patient Philadelphia, U.S.A. had been coughing up in excess of 20 ounces of bile-stained material daily. This would come up APNOEA ON CESSATION OF CONTROLLED in amounts up to an ounce at a time. He had RESPIRATION been running a septic fever in spite of all manner of antibiotics, his weight had shrunk to a mere Sir,—In the June issue of the Journal, Dr. 85 pounds, and his pulse rate hovered around 140 Wylie discussed the possible causes of persistent per minute. The proposed operation was an apnoea after prolonged controlled respiration. exploration of the liver for an abscess, the surgical I found Dr. Wylie's explanations most interapproach being through the bed of the 12th rib esting, but it appeared to me that for the most with the patient in the lateral position right side part they dealt with persistent apnoea following up. It was felt that a general anaesthesia would be an overdose, absolute or relative, of anaesthetic needed for an adequate exploration. An endo- agents or muscle relaxants. Manual ventilation bronchial technique seemed the only answer to for apnoea due to these causes, to my mind, should general anaesthesia sine inundation. be referred to as " artificial" rather than conHaving no special endobronchial tubes or trolled respiration. I believe that the term " conblockers, we fashioned an endobronchial technique trolled respiration " should be reserved for that out of a regular 5/40 Jackson bronchoscope and type of respiration in which voluntary respiratory a No. 8 portex Magill tube. It was found that if movement has been abolished but where spon513