Nitrous oxide-oxygen-ether anaesthesia: No. 3 (1944)

[@peterfslife]

This is SO profound!!! You know, when we think of the anesthetic machine, now days we see display screens, electronic flowmeters, modes like Pressure Support, and Volume Control, and Spont/Man mode. Back then, these modes weren't in existance. THERE WAS NO VENTILATOR on the machine. YOU, the anesthesiologist, were the ventilator, and you did it with the rubber bag that you squeezed every five or so seconds. And you didn't have the ETCO2 we have now days to gauge how much ETCO2 was present. You didn't have a tidal volume numeric. You did not have a PEEP numeric. Back then, drugs like Propofol and Thiopental weren't in existance. And when IV drugs were a thing, and Thiopental was administered, It wasn't as simple as the Propofol and the BIS monitor we see all over operation rooms now days. You didn't have Vecuronium, or Cisatracurium. You had medications like D-Tubocurarine. Or Sux. Things have changed so much! SO MUCH!!! And It's interesting to visualize how much they changed. Back at the time, the old Boyle's machine was a GREAT volatile delivery system.

[@gaggymott9159]

It's crazy to think that this apparatus was being used for casualties and War emergencies during WWII in the UK....😮

[@DigitalAndInnovation]

This hands on approach is insane- "just smell the volitiles to see if they are still good". wow

[@pretoasted]

Don't worry, they'll say the same about plenty of the things we do now in ~50 years or so; Just how things go (at least so far).

[@DigitalAndInnovation]

@@pretoasted I am sure- it is so crazy how the frame of reference changes faster and faster these days!

[@andrijsorenko2045]

10 liter nitrous to 1 liter of oxygen and then increase to 5 liter nitrous and 1 liter oxygen :) i wish i could put the saturation detector on those patients :)

[@lucifchristo]

This is crazy method

[@joestevenson5568]

FiO2 of 20% should be fiiiiiine.

[@juliedickens2787]

Interesting that the airway goes in the right way round.

[@habibi9200]

Can somebody explain the purpose of the long nozzle attached to the facemask. In one scene it is situated at the nose end. In another later scene it is situated at the mouth end ???

[@rudern8]

The nozzle is for pumping/filling air in the rubber facemask rim, it's perfect for a gas tight fit of the smelly rubber latex mask and the patients face. Rubber rebreathing bag and breathing hoses where also very smelly with the use of ether, the time of "Rubber Anesthesia".

[@firstboy5479]

Это для того чтобы язык не упал и не перекрыл ход газа.

[@habibi9200]

Why is there a carbon dioxide bottle ? Can someone please explain... and why does the narrator say it can be disregarded ? The same goes for the chlroform. I thought chloroform was the preferred anaesthetic out of ether and chloroform. I'm confused.

[@BeniSilver]

Pure O2 is toxic if administration is prolonged. CO2 stimulates respiration. I presume the CO2 is used when N2O isn't. IIRC, chloroform, was discovered first, but it is even more irritating than ether.

[@habibi9200]

Thank you for clarifying Ben. I'm assuming the reason the narrator says the carbon dioxide bottle can be disregarded is because the oxygen bottles are air, rather than pure oxygen ?...so no carbon dioxide is needed. But I am wondering why carbon dioxide bottles were ever needed in the first place ? Ether is awful stuff. I bought a can in a french pharmacy to test out of curiosity. It smells dreadful...really, really strong. I don't understand why it's often described as "sweet, pleasant smelling". It smells terrible !!!

[@BeniSilver]

habibi9200 It is pure O2, not air. The apparatus has more than one use. As the title says, they are describing N20-02-ether anaesthesia. I'd say that they both smell sweet. Both irritate nasal mucosa, though.

[@pascalbondon2308]

I suppose the CO2 bottle can be disregarded because the machine uses partial rebreathing, as explained from 17:37 : much of the expired gas (containing CO2) is inhaled again by the patient while inspiring ; so no addionnal CO2 is required under normal conditions. I do not know under which circumstances it s necessary to add more CO2, perhaps if the size of the balloon is unadequate, or in case of spasms, in order to correct excessive alkalinity of the patient's blood.

[@joestevenson5568]

The CO2 is to stimulate the patients respiratory drive.

[@juliedickens2787]

God help latex allergic patients!