By R. Miller
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Extra info for Anesthesia [2 vols]
Related to genetics is the fetal loss or development of fetal malformations that may occur when a pregnant woman is exposed to a variety of drugs, with some anesthetics suspect at least in animal experiments. 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) . 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. Not long after its introduction, methoxyflurane was discovered to induce a rare kind of renal failure with tubular necrosis, characterized by high urinary output that was unresponsive to vasopressin.
Copyright © 2000 Churchill Livingstone, Inc. INTRAVENOUS ANESTHESIA We have cited the experiments of Wren and Major in introducing medicinals into the circulation, quick upon Harvey's description of the circulation (Chs. 8 and 11) . Around the 1850s, the hypodermic hollow needle and glass and metal syringes were introduced via the inventions of Scotsmen Francis Rynd (1845) and Alexander Wood (1855) and Charles Gabriel Pravaz (1853). Although these improvements over the quill and bladder were to herald both intravenous and regional anesthesia, Rynd and Wood were making injections into the vicinity of nerves for the relief of neuralgia, and Pravaz injected ferric chloride via trocar into arterial aneurysms in an attempt to induce thrombosis.
Anesthesia [2 vols] by R. Miller