Controversies in Cardiovascular Anesthesia

ISBN-13: 9780898389852 / Angielski / Twarda / 1988 / 192 str.

Phillip Fyman; Alexander W. Gotta; Phillip N. Fyman

Opis

On 16 October 1846, an itinerant New England dentist named William T. G. Morton proved the anesthetic effect of diethyl ether in a public demonstration in the "ether dome" of the Bulfinch Building of the Massachusetts General Hospital in Boston. The patient, Gilbert Abbott, suffered no pain, and the surgeon, Dr. John C. Warren, was able to complete a suture ligature of a vas- cular tumor of the jaw without the hurry that until then was so necessary. The operation proved a failure, since the tumor recurred; but the demonstration of ether's anesthetic effect was a great success. Operative pain was conquered, and surgery could advance from a crude and unscientific practice where speed was paramount, and the major body cavities could not be entered, into the unique blend of science and art that it is now. "Gentlemen, this is no hum- bug," supposedly muttered Warren, perhaps the last noncontroversial assess- ment of anesthesiology to be made by a surgeon. The screams of resisting patients in pain were stilled, and quiet entered the operating room for the first time. But the new science of pain relief was quickly wrapped in controversy. An argument immediately arose as to who could legitimately claim primacy for the discovery. Morton's attempt to hide the true nature of his anesthetic agent, coupled with an effort to patent the discovery, clouded his reputation and stimulated other claimants to push themselves forward.

Spis treści

1. An inhalation anesthetic technique is preferable for patients undergoing coronary artery bypass grafting.- 2. An intravenous technique is preferable for patients undergoing coronary artery bypass grafting.- 3. Blood gas values should be corrected for body temperature during hypothermia.- 4. Blood gases should not be temperature corrected during hypothermia.- 5. High pump flows and pressure are desirable during cardiopulmonary bypass.- 6. Low pressure during cardiopulmonary bypass is preferable.- 7. Pulmonary artery catheters should be used routinely in all patients undergoing coronary artery bypass grafting.- 8. Routine insertion of pulmonary artery catheters is not necessary in all patients undergoing coronary artery bypass grafting.- 9. General anesthesia is preferable for patients undergoing carotid endarterectomy.- 10. Regional anesthesia is preferable for patients undergoing carotid endarterectomy.