Shock in Operations

Sun (Auckland), Volume II, Issue 486, 16 October 1928, Page 1

Shock in Operations

IS ANAESTHETIC TO BLAME? Auckland Surgeons’ Opinions THERE is no hard and fast rule about the use of anapsI thetics, local and general, according to Auckland surgeons who to-day comincmted on the theory of an American, Dr. Robert Neale.

According to a cable message, Dr. .Neale holds that the shock a patient suffers in a major operation is clue more to the anaesthetic than to the operation itself. To prove his theory he operated on himself for appendicitis with only a local anaesthetic and came through it well. -I have seen surgeons operate on themselves, but never sit up and open up their abdomens,” commented one Mirgeon. ‘‘lt would certainly be a difficult operation.” NOT FOR NERVOUS Another surgeon said, “Therr is a certain amount of truth in the statement, but all operations cannot be tarried out with only a local anaesthetic. With a very muscular man or u nervous person the local would not give sufficient relaxation. "Nervous and neurotic patients would often imagine they were feeling pain with a local, when they really could feel nothing.” He explained that the use of local or general anaesthetics depended on the preference of the surgeon. Some .surgeons preferred and some tried to avoid locals. The local anaesthetic took longer to administer and about 15 nr -0 minutes had to elapse afterwards before the operation could start, so that for emergency work chloroform or ether were the handiest. Summing up, he said the choice of anaesthetic depended on (1) the

condition of the patient, (2) the site or organ of the operation, and (3) the length and severity of the operation. Local anaesthetic did not do away with shock. Often in amputation a patient’s mental anxiety was quietened with morphia and then a local was used. “Much can be said on both sides,” he continued, “but there can be no sweeping assertion.” ACCORDING TO THEORIES Appendicitis operations with the use of local anaesthetics have been carried out in Auckland for the last 10 years, another surgeon explained. He often adopted the local when a patient was suffering from a cough which would break open the wound. The method was to inject a synthetic anaesthetic so as to block the line of nerves, and to cause all feeling to leave the part to be operated upon. Individual surgeons acted according to their theories. “To say that shock is due entirely to the anaesthetic is quite wrong,” he said. “Many features of the operation, the fright, damage to tissue, and loss of blood, apart from the pain, all go to produce shock.” He pointed out that while a general anaesthetic put the patient to sleep the brain was still recording the damage of the operation. The local cut off the part from all contact with the brain until after the operation.