ACCIDENTS OP GENERAL ANESTHESIA. 75 



ACCIDENTS OF GENERAL ANESTHESIA. 



Notwithstanding the caution observed in the use of ether or 

 chloroform, and however pure these articles may be, accidents must 

 be expected during their administration. They are not always of 

 a serious nature, but they may at times have fatal results. 

 Among those of minor importance is the cough which becomes 

 at times quite troublesome, but may be readily subdued by a tem- 

 porary arrest of the inhalation ; vomiting, which often occurs in 

 small animals, but which can be guarded against by causing the 

 patient to fast long enough to insure an empty stomach before 

 being etherized, and spasmodic contractions, of which the exis- 

 tence, when undoubtedly present, is often overlooked. Among 

 those of more serious nature are syncope, either cardiac or res- 

 piratory. 



Cardiac syncope is a very serious accident, and in a majority 

 of cases proves fatal, especially in large animals. It is sudden in 

 its manifestation, and often unobserved until at too late a period 

 of the operation. It is due to a gradual diminution, followed by 

 am arrest of the muscular contractions of the heart, and as far as 

 our observation extends is always associated with pre-existing 

 heart disease. The application of cold douches, of heart stimu- 

 lants, ammonia given by inhalation or internally, are the first in- 

 dications in these cases. 



Respiratory syncope, which is far less dangerous, arises from 

 the influence of the laryngeal nerves upon the activity of the res- 

 piratory centers. Its access is sudden, being caused by the arrest 

 of the respiration. There is no convulsion, though the intoxica^ 

 tion produced by the anesthetic vapors is sudden in its effects, and 

 is generally detected only by careful watching. 



The application of electricity, that of the electro-puncture, and 

 especially persevering efforts to effect artificial respiration, may 

 sometimes save the animal, provided the trouble is not connected 

 with the complete arrest of the contractions of the heart. 



In view of these possible incidental conditions, some general 

 rules suggest themselves tending to their avoidance. Great care 

 and exactness in gauging the doses of the anesthesia, with such 

 caution in their administration as to produce a slow and gradu- 

 ated effect, is one point. Free allowance for the introduction of 

 air with the vapors inhaled ; close attention to the state of the 



