Basal narcosis: with special reference to the use of tri-bromethanol (Avertin)

Abstract

CONCLUSIONS: (1) Every patient about to undergo a surgical operation should have the benefit of basal narcosis in some shape or form. (2) At the present time Avertin is the most satisfactory and generally applicable basal narcotic available. (3) Avertin is invariably safe if a dosage of 1 gram per kilogram of bodyweight be not exceeded. (4) Morphia should not be used as a premedicament as it is unnecessary and adds to the risk. (5) Avertin is essentially a basal narcotic and not a general anaesthetic. (6) The supplementary anaesthetic is of great importance in obtaining successful after -results and a simple technique for its administration is detailed. Emphasis is laid on the use of CO₂ and oxygen after operation. (7) Avertin may be used with advantage in obstetrics but it is probably inferior to nembutal and chloral as a routine anaesthetic, especially where working single-handed. (8) Practically every surgical condition can be dealt with under avertín. The contra-indications to its use are according to the condition of the patient rather than to the procedure to be adopted, with the exception of operations on the anus and rectum, and tonsillectomy. (9) Tonsillectomy should not be performed under avertin unless a special technique is adopted. (10) Certain conditions of the patient are better treated by avertie than by other means. These are cases of thyroid disease, diabetes, heart cases and all patients of a particularly nervous temperaument. (11) There is a definite .field for the use of avertie in ophthalmology. (12) In the foregoing series of cases the results of Avertin narcosis were uniformly satisfactory (with the exception of the two tonsil cases mentioned above) and post -operative complications were conspicuous by their absence.

Though the series is small it covers many different varieties of surgical procedure and the results obtained have been so successful as to warrant the continued use of the drug.