Download e-book for iPad: Anesthesia [2 vols] by R. Miller

By R. Miller

ISBN-10: 0443079889

ISBN-13: 9780443079887

ISBN-10: 044307996X

ISBN-13: 9780443079962

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Sample text

Although an altered sensitivity to halothane was deemed responsible by some, a more convincing explanation implicated toxic metabolites induced by hypoxia as the cause. Only recently has evidence reappeared for an immunologic basis of the lesion (Ch. 6) . Following these events, research on anesthesia began to reach its stride. First, the unsuspected fact emerged that inhaled anesthetics that were formerly considered inert were indeed metabolized in various degrees; for example, halothane was 20 percent metabolized, and methoxyflurane was 50 percent metabolized.

The general practitioner did all the work, and although the easterners began to loom as specialists and leaders, a good deal of emphasis was placed on practice as a business, with medical education at a low level. The only medium for scientific publication in the first part of the 19th century was the Transactions of the Royal Society. At the turn of the century, a class of physicians emerged that was clearly identified with anesthesia. " Three figures stand out in this regard, Waters among them.

One consequence of the putative adverse fetal effects was the initiation of epidemiologic studies that purported to show that the pregnant woman involved in operating room activities (nurses, anesthesiologists, and wives of anesthesiologists) could be exposed to trace anesthetic gases. A higher incidence of fetal loss was claimed, which led to the expensive installation of scavenging systems and the revival of closed-system anesthesia techniques with all of their complexities (Chs. 6 and 84) . The development of contemporary anesthesia can be embellished by citing the improvement in anesthetic apparatus and monitoring systems toward greater safety or, on the pharmacologic side, continued search for the basis of narcosis at the molecular level.

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Anesthesia [2 vols] by R. Miller


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