Quotation from: Manual of SurgeryWritten by: Alexander Miles and Alexis Thomson |
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_Prevention of Operation Shock._--In the preparation of a patient for operation, drastic purgation and prolonged fasting must be avoided, and about half an hour before a severe operation a pint of saline solution should be slowly introduced into the rectum; this is repeated, if necessary, during the operation, and at its conclusion. The operating-room must be warm--not less than 70 F.--and the patient should be wrapped in cotton wool and blankets, and surrounded by hot-bottles. All lotions used must be warm (100 F.); and the operation should be completed as speedily and as bloodlessly as possible. The element of fear may to some extent be eliminated by the preliminary administration of such drugs as scopolamin or morphin, and with a view to preventing the passage of exciting afferent impulses, Crile advocates "blocking" of the nerves by the injection of a 1 per cent. solution of novocaine into their substance on the proximal side of the field of operation. To prevent after-pain in abdominal wounds he recommends injecting the edges with quinine and urea hydrochlorate before suturing, the resulting anaesthesia lasting for twenty-four to forty-eight hours. To these preventive measures the term _anoci-association_ has been applied. In selecting an anaesthetic, it may be borne in mind that chloroform lowers the blood pressure more than ether does, and that with spinal anaesthesia there is no lowering of the blood pressure.
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