3 - History of Anaesthesia Society

More documents

Recommendations

Info

Drs M Goerig, W Pothmann, H Polcar Estcess anaesthetic gave3 polluting the air in oprating rooms may result n detrimental effects for ,311, worlcers in that In rzcent years renewed efforts have been made both to develop new scavenging app~atus, and to let everyone involved with inhalat'o a1 anaesthetics !mow abut the pssible side-effects of their vapours. 2-3 The first ~nentian of the existence of excess gases and associated sideeffacts occurred in 1889 when h-0f.G van Overbeek de Meyer, a microhioluqist at the Reichsuniversitat of Utrecht, pointed out the ~ssibility of an interactio 'ktween chlorofon and incident gas light if us-ci at the same the.'' He discr,~ssed the quality of air in the theatre, adding that he had never noticed this phenomenon when chloroform or ether was used alone. His ohsewation initi t~ disc~lssion about the problem, which has yet to be fully resolved. 3-fkl a A few weks latx, an ophthalmlogist at the University of Fxlangen, near Nursmburg, Prof.von Eversbusch gave a more detailed description of slde-effect5. He had observed symptoms: coughing, headache and mucous secretmn of the nose and eyes, men h and his colleagues had worked longer than wll?~l Ln such pLlut?d airJ7 He s13w pollution as the main calise of these symptorits and recmendwl intensive ventilation of theatr?s as the best method of prevention. Another preventive mathod, he felt, was the prnduction of hi7h humidity, to absorb the polluting rmlecules . Intrnslve research followd to identify the toxic gases. In 1891, P~wf.von Pettenkover, Chairman of the Institute of Microbiology of the UnLverslty of Mun~ch, pblished his ~esults in a review article.'' In hls laboratory, the main toxic substances were identified as chlorine and hydrochlor~c acld. mth gasas were well-known at the time for their toxic praperties which could produce symptoms comparable to those reported in the medical journals. During the following years, few publisheA articles dealt with excess gases, probably as a r~sult of modernisation, such as he use of electricity in hospitlls, and especially in theatres.' Another explmation may lie in the rediscwery of ether for anaesthe~ia which led to a more intensive use of this agent. Degradation by gas light of this agent has never been descril~d as its explosive proprties prevent it being used in t'le presence of an open flame. With the tremendous progress of locsL anaeqthetic techniques during the next decades the problem seemed to receje. Wen mentioned, the problems of excess gases wpre considered as minor. Wor'cers s~lfficiently concerned to recognise the rnssible hazards includd two EerLin surgeons, Unger and ~ettmann.~O When rewrting t:-e results of their experience with the apnoeic insufflation technique of anaesthesia, they noted problems, esp-iaLly for the anaesthetist, from atmus&eric pollution. Similar
effects were noted during the use of the Sauerbruch chamber for thoracic =gery. In 1918 a Dresden surgeon, Kelling, reprted in a surgical journal on the various problems caused by excess g ses and the intolerable situation they caused for all affected staff .'l He designed a specially sham anaesthetic mask for effective removal of the vapur. During suhjequent years, Kelling published sev a articles reprting some of his methais for overcoming the (Figure 1) in retrospect, his developcents were highly effective and his contributions to the field deserve wider recognition. Just when Kelling was drawing attention to the existence of excess gases, the American pioneer in anaesthesia, Francis Mctlechan, pointed out in an obituary the detrimental effects of ch nic inhalation of excess gases. 38 * colleague was said to have died of cRronic inhalation of narcotics. - PlcMechan wrote: 'We know what , protective measures mist be used by radiologists, but so far medical I science has not forced the protection required for those who --- . --. give anesthetics'. The next to ccnnnent on pollution was the Gemn Perthes, (of Rrthes' dissase) ad well-known for his method of localising peripheral nerves the use of an electric current. 't28 In 1925, he described a specially designad exhaust fan with an inlet close ta the patient's head. (Figure 2) Within five minutes, the air in the theatre could be ccmpletely renewed, resulting in improved well-being in his staff. K, In the sm year, Kirschner suggested the advantageous use of fans to dissipate the anaesthetic away f r m the surgeon within the theatre?' In retrospect, this w3s a step backrvards as t\e gases were not eliminated, in contrast to the
Page 3: Zhe History of Anaesthesia Society
Page 6 and 7: PARTICIPANTS AT TllE RO1TERDAM MEET
Page 8 and 9: haerrorrhage and the administration
Page 10 and 11: Pimot did not believe that dentists
Page 12 and 13: was visited by mny friends, colleag
Page 14 and 15: increased. In haloperidol the neuro
Page 16 and 17: 9000 times as potent as pethidine a
Page 18 and 19: Flacke JW et al. Comparison of morp
Page 20 and 21: he seems as dead'. It is clear from
Page 22 and 23: 1 Landon, H.C.Robbins Ed. The Colle
Page 24 and 25: dogs with a cl system. His reprt of
Page 26 and 27: the times when carbon dioxid is mst
Page 28 and 29: 'The salient characteristic of the
Page 30 and 31: Griffith, well imderstood the imprt
Page 32 and 33: Professor J J de 'Lange, Drs M A Cu
Page 34 and 35: Mter twenty mnuted he carried out a
Page 36 and 37: Dr J M Hot-ton (Cambridge) Denis Br
Page 38 and 39: -mtient, by mans of a cylinder fitt
Page 40 and 41: Professor H Reinhold (73nlssels) Hi
Page 42 and 43: In the early pst-mr perid the neces
Page 44 and 45: Most anaesthetics were still given
Page 48 and 49: Figure 2. E@rthegs Device (1925) me
Page 50 and 51: Cohen EN et al. Occupational diseas
Page 52 and 53: Drs J Samarutel, A Yivic, E Kross,
Page 54 and 55: than 170 in 1991. TCIe EARS holds r

3 - History of Anaesthesia Society

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?