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Modern Trends in Anaesthesia
394
BRITISH JOURNAL OF ANAESTHESIA ZUSAMMENFASSUNG
Narconumal und Narcodortn sind chemisch miteinander nahc verwandte methylierte Oxybarbiturate. Die pharmakodynamischen Charakteristika dieser Verbindungen werden miteinander sowie mit jenen des Thiopentons als dem Standardmedikament verglichen. Beide Pharmaka zeigen zu anderen methylierten Oxybarbitursaurederivaten, dem Hexobarbiton z.B. oder dem Methohexiton, insofern ein
analoges Verhalten als sie in einem ziemlich hohen Prozentsatz Erregungserscheinungen hervorrufen. Diese Exzitationsphanomene sind bei alleiniger vorausgehender Anwendung von Atropin dcutlicher ausgepragt als wenn auch zugleich Opiate vorher gegeben werden. Ein mit beiden Medikamenten haufig einhergehender Befund ist eine Blutdrucksenkung. Aufgrund des im Narcodorm enthaltenen Brom-Atoms entfaltet dieses Medikament eine etwas intensivere Wirkung als das Narconumal.
Modern Trends in Anaesthesia. Edited by Frankis T. Evans and Cecil Gray. Published by Butterworths. Pp. viii + 219; 14 illustrations; 5 tables. Price 60s. It has been fashionable for some time now for our colleagues in other fields of medicine to praise loudly the rapid advances in anaesthetic methods. The equally rapid advances in the paraclinical sciences of biochemistry and applied physiology, and pharmacology which have such an important bearing on anaesthesia have not received so much attention. If anaesthesia is to advance beyond its present high level of largely empirical technical development, it must absorb a great deal of knowledge from these other fields. This book sets out to build one or two firm, if unpretentious, bridges between the anaesthetist on the one hand and the physiologist and biochemist on the other. The eight chapters cover a range of subjects from hydrogen ion regulation and the measurement of pH to the cholinesterases. Five are written by anaesthetists and three by experts in other fields. As might have been expected those written by anaesthetists—Nomenclature and presentation of hydrogen ion regulation data; The measurement of pH and Pco2; The effects of hypercapnia; Hyperventilation; Some trends in the biochemistry of anaesthesia —will on the whole be more useful to anaesthetists because the material has, so to speak, already been digested by someone sensitive to their needs. The other three chapters are on: Acid base balance in hypothermia; Acid base changes due to cardiac bypass; The cholinesterases. They are likely to be of more value as source material rather than as basic explanation. Very full reference lists are given at the end of each chapter, the illustrations, though not many, are clear, and the index is excellent. This book is first-rate serious reading for the anaesthetist who wants to understand and apply to his work present-day scientific knowledge in the physiological
and biochemical field. It can be thoroughly recommended. If there is any regret, it is that the editors, with their great teaching ability, did not contribute chapters themselves. W. W. Mushin Diethyl Ether. By Robert B. Dodd, with a chapter on "Metabolic Effects" by John P. Bunker. Published by Charles C. Thomas, Illinois, U.S.A. Pp. xii + 120; 5 illustrations, 3 tables. Price 30.J. Dr. Dodd attempts to do for ether what Ralph Waters did for chloroform. However, whereas the latter reported a planned research programme this volume gathers together, mostly in mention form, what is known about ether from a very wide range of modern authorities. In contrast to the comprehensive review of the literature on the pharmacology of ether which is compressed into the comparatively small number of 78 pages, there is a somewhat liberal restatement of Haggard and Kety's work on the absorption and distribution of ether which occupies 15 of them. This is not a book to be read lightly or even consecutively but rather one to be referred to when any point concerning ether arises. The 485 references at the end will be sure to give an answer. The author is clearly of the opinion that ether "meets biological and statistical requirements" of the ideal anaesthetic agent, not only because he gives the impression of emphasizing the good points of ether whenever possible but because he says so on the last page. The reader, however, must not expect a clear line of argument towards this end running through the book. The greater part of the text consists of an excellent and concise reference source of the very considerable modern literature on the pharmacology of ether. There are only 5 illustrations, but why they were chosen from among the hundreds which must have been equally available or helpful is not clear. W. W. Mushin
Downloaded from http://bja.oxfordjournals.org/ at UB der TU Muenchen on July 14, 2015
BOOK REVIEWS
BRITISH JOURNAL OF ANAESTHESIA ZUSAMMENFASSUNG
Narconumal und Narcodortn sind chemisch miteinander nahc verwandte methylierte Oxybarbiturate. Die pharmakodynamischen Charakteristika dieser Verbindungen werden miteinander sowie mit jenen des Thiopentons als dem Standardmedikament verglichen. Beide Pharmaka zeigen zu anderen methylierten Oxybarbitursaurederivaten, dem Hexobarbiton z.B. oder dem Methohexiton, insofern ein
analoges Verhalten als sie in einem ziemlich hohen Prozentsatz Erregungserscheinungen hervorrufen. Diese Exzitationsphanomene sind bei alleiniger vorausgehender Anwendung von Atropin dcutlicher ausgepragt als wenn auch zugleich Opiate vorher gegeben werden. Ein mit beiden Medikamenten haufig einhergehender Befund ist eine Blutdrucksenkung. Aufgrund des im Narcodorm enthaltenen Brom-Atoms entfaltet dieses Medikament eine etwas intensivere Wirkung als das Narconumal.
Modern Trends in Anaesthesia. Edited by Frankis T. Evans and Cecil Gray. Published by Butterworths. Pp. viii + 219; 14 illustrations; 5 tables. Price 60s. It has been fashionable for some time now for our colleagues in other fields of medicine to praise loudly the rapid advances in anaesthetic methods. The equally rapid advances in the paraclinical sciences of biochemistry and applied physiology, and pharmacology which have such an important bearing on anaesthesia have not received so much attention. If anaesthesia is to advance beyond its present high level of largely empirical technical development, it must absorb a great deal of knowledge from these other fields. This book sets out to build one or two firm, if unpretentious, bridges between the anaesthetist on the one hand and the physiologist and biochemist on the other. The eight chapters cover a range of subjects from hydrogen ion regulation and the measurement of pH to the cholinesterases. Five are written by anaesthetists and three by experts in other fields. As might have been expected those written by anaesthetists—Nomenclature and presentation of hydrogen ion regulation data; The measurement of pH and Pco2; The effects of hypercapnia; Hyperventilation; Some trends in the biochemistry of anaesthesia —will on the whole be more useful to anaesthetists because the material has, so to speak, already been digested by someone sensitive to their needs. The other three chapters are on: Acid base balance in hypothermia; Acid base changes due to cardiac bypass; The cholinesterases. They are likely to be of more value as source material rather than as basic explanation. Very full reference lists are given at the end of each chapter, the illustrations, though not many, are clear, and the index is excellent. This book is first-rate serious reading for the anaesthetist who wants to understand and apply to his work present-day scientific knowledge in the physiological
and biochemical field. It can be thoroughly recommended. If there is any regret, it is that the editors, with their great teaching ability, did not contribute chapters themselves. W. W. Mushin Diethyl Ether. By Robert B. Dodd, with a chapter on "Metabolic Effects" by John P. Bunker. Published by Charles C. Thomas, Illinois, U.S.A. Pp. xii + 120; 5 illustrations, 3 tables. Price 30.J. Dr. Dodd attempts to do for ether what Ralph Waters did for chloroform. However, whereas the latter reported a planned research programme this volume gathers together, mostly in mention form, what is known about ether from a very wide range of modern authorities. In contrast to the comprehensive review of the literature on the pharmacology of ether which is compressed into the comparatively small number of 78 pages, there is a somewhat liberal restatement of Haggard and Kety's work on the absorption and distribution of ether which occupies 15 of them. This is not a book to be read lightly or even consecutively but rather one to be referred to when any point concerning ether arises. The 485 references at the end will be sure to give an answer. The author is clearly of the opinion that ether "meets biological and statistical requirements" of the ideal anaesthetic agent, not only because he gives the impression of emphasizing the good points of ether whenever possible but because he says so on the last page. The reader, however, must not expect a clear line of argument towards this end running through the book. The greater part of the text consists of an excellent and concise reference source of the very considerable modern literature on the pharmacology of ether. There are only 5 illustrations, but why they were chosen from among the hundreds which must have been equally available or helpful is not clear. W. W. Mushin
Downloaded from http://bja.oxfordjournals.org/ at UB der TU Muenchen on July 14, 2015
BOOK REVIEWS