Abstract:
:Although Ernest Shackleton's Endurance Antarctic expedition of 1914 to 1916 is a famous epic of survival, the medical achievements of the two expedition doctors have received little formal examination. Marooned on Elephant Island after the expedition ship sank, Drs. Macklin and McIlroy administered a chloroform anesthetic to crew member Perce Blackborow to amputate his frostbitten toes. As the saturated vapor pressure of chloroform at 0°C is 71.5 mmHg and the minimum alveolar concentration is 0.5% of sea-level atmospheric pressure (3.8 mmHg), it would have been feasible to induce anesthesia at a low temperature. However, given the potentially lethal hazards of a light chloroform anesthetic, an adequate and constant depth of anesthesia was essential. The pharmacokinetics of the volatile anesthetic, administered via the open-drop technique in the frigid environment, would have been unfamiliar to the occasional anesthetist. To facilitate vaporization of the chloroform, the team burned penguin skins and seal blubber under overturned lifeboats to increase the ambient temperature from -0.5° to 26.6°C. Chloroform degrades with heat to chlorine and phosgene, but buildup of these poisonous gases did not occur due to venting of the confined space by the stove chimney. The anesthetic went well, and the patient-and all the ship's crew-survived to return home.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Firth PGdoi
10.1097/ALN.0000000000001151subject
Has Abstractpub_date
2016-07-01 00:00:00pages
25-33issue
1eissn
0003-3022issn
1528-1175journal_volume
125pub_type
历史文章,杂志文章相关文献
ANESTHESIOLOGY文献大全abstract::Anesthetic exposure is usually necessary but rarely sufficient to the conduct of therapy. Consequently, there is a natural abhorrence of any worsening of a patient's condition secondary to the administration of anesthesia, which offers the patient no direct benefit. Highly safe anesthesia is a necessary precondition...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197812000-00002
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:Ketamine is a commonly used anesthetic, but the mechanistic basis for its clinically relevant actions remains to be determined. The authors previously showed that HCN1 channels are inhibited by ketamine and demonstrated that global HCN1 knockout mice are twofold less sensitive to hypnotic actions of ketamine...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318287b7c8
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Studies using transthoracic thermodilution have demonstrated increased extravascular lung water (EVLW) measurements attributed to progression of edema and flooding during sepsis and acute lung injury. The authors hypothesized that redistribution of pulmonary blood flow can cause increased apparent EVLW secon...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181bc99cf
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to compare the effects of goal-directed colloid fluid therapy with goal-directed crystalloid and restricted crystalloid fluid therapy on healthy and perianastomotic colon tissue in a pig model of colon anastomosis surgery. METHODS:Pigs (n = 27, 9 per group) were anesthetized and me...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31819841f6
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Cardiac surgery requiring the use of cardiopulmonary bypass is frequently complicated by coagulopathic bleeding that, largely due to the shortcomings of conventional coagulation tests, is difficult to manage. This study evaluated a novel transfusion algorithm that uses point-of-care coagulation testing. MET...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000556
更新日期:2015-03-01 00:00:00
abstract::To determine whether neuronal firing is affected by anesthetics, the behavior of neurons in the mesencephalic reticular formation in response to repetitive somatosensory stimulation at 2/sec was studied during wakefulness and during nitrous oxide, halothane, and thiopental anesthesia in the cat. With clinical doses of...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197710000-00005
更新日期:1977-10-01 00:00:00
abstract::Positive pressure ventilation can affect hemodynamic stability by neuroreflex-mediated activity. Inhalational anesthesia is known to attenuate the arterial baroreflex function; however, little information is known about the effect of volatile anesthetics on the lung inflation reflex. The influence of isoflurane on sta...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199206000-00017
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Acid-sensing ion channel 3 (ASIC3) upregulation has been reported in dorsal root ganglion neurons after incision and contributes to postoperative nociception. This study hypothesized that upregulation of ASIC3 in incised tissues is induced by nerve growth factor through the phosphoinositide 3-kinase/protein ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003576
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Forced-air warming is sometimes unable to maintain perioperative normothermia. Therefore, the authors compared heat transfer, regional heat distribution, and core rewarming of forced-air warming with a novel circulating-water garment. METHODS:Nine volunteers were each evaluated on two randomly ordered study...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200405000-00005
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Moxonidine, a novel imidazoline-alpha2-adrenergic receptor-selective analgesic, was recently identified as antinociceptive but has yet to be evaluated in neuropathic pain models. alpha2-adrenergic receptor-selective analgesics, and high-efficacy opioids, effectively inhibit neuropathic pain behaviors in rode...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200009000-00026
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Several beneficial effects of local anesthetics (LAs) were shown to be due to inhibition of G protein-coupled receptor signaling. Differences in exposure time might explain discrepancies in concentrations of LAs required to achieve these protective effects in vivo and in vitro (approximately 100-fold higher)...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200404000-00015
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:The spinal delivery of the cholinesterase inhibitor neostigmine yields analgesia in rats and augments the analgesic effects of alpha 2 agonists in sheep. To assess its activity in humans, preclinical toxicology studies to define its safety were required in two species. METHODS:Rats with chronic intrathecal ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199502000-00012
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:A combination of opioid and nonopioid analgesic drugs may improve the quality of postoperative analgesia as well as reduce opioid requirements and their associated side effects. Studies have shown synergism between gabapentin and morphine in animal and human experiments and in the treatment of incisional pai...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200404000-00025
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:The Pediatric Craniofacial Collaborative Group established the Pediatric Craniofacial Surgery Perioperative Registry to elucidate practices and outcomes in children with craniosynostosis undergoing complex cranial vault reconstruction and inform quality improvement efforts. The aim of this study is to determ...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/ALN.0000000000001481
更新日期:2017-02-01 00:00:00
abstract::Halothane-induced lipid peroxidation was studied in microsomes from phenobarbital-pretreated male rats at defined steady state oxygen partial pressures (PO2). At PO2 less than 10 mmHg on addition of halothane to NADPH-reduced microsomes, significant increases in malondialdehyde (MDA) formation, oxygen uptake, and conj...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198501000-00009
更新日期:1985-01-01 00:00:00
abstract:BACKGROUND:The myocardial negative inotropic effects of desflurane are less pronounced than those of other halogenated anesthetics, partly because of intramyocardial catecholamine store release. However, the effects of desflurane on aging myocardium are unknown, whereas aging is known to be associated with an attenuati...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200611000-00017
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:A focal cortical cryogenic brain injury has been reported to reduce the brain pentobarbital concentrations needed to prevent movement in response to pain in rats. This occurred despite any apparent behavioral changes in the awake animals. To determine whether this was true with other anesthetics, the authors...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199307000-00020
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND:Acute kidney injury is a common complication after cardiac surgery, leading to increased morbidity and mortality. One suggested cause for acute kidney injury is extracorporeal circulation-induced ischemia-reperfusion injury. In animal studies, cyclosporine has been shown to reduce ischemia-reperfusion injury...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0000000000002104
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Previous experimental and clinical studies have shown that anesthetic agents have varying effects on cancer prognosis; however, the results were inconsistent among these studies. The authors compared overall and recurrence-free survival in patients given volatile or intravenous anesthesia for digestive tract...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003440
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Sympathetic nerve activity was recorded in the leg during high thoracic epidural anesthesia with a segmental sensory blockade of the upper thoracic dermatomes to test the hypothesis that the sympathetic blockade accompanying thoracic epidural anesthesia includes caudal parts of the sympathetic nervous system...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-199911000-00021
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Neuroligin-1 (NL1) forms a complex with the presynaptic neurexin-1β (Nrx1b), regulating clustering of N-methyl-D-aspartate receptors with postsynaptic density-95 (PSD-95) to underlie learning-/memory-associated plasticity. Pain-related spinal neuroplasticity shares several common features with learning-/memo...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000809
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) is still common, especially among female patients. Our hypothesis is that coinduction with clonidine reduces the incidence of PONV in adult patients undergoing breast cancer surgery. METHODS:Sixty-eight women premedicated with midazolam were randomly allocated to coi...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200205000-00013
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Nitric oxide (NO) formed from L-arginine is exhaled by mammals and regulates pulmonary vascular tone. Little is known about how its formation is stimulated. METHODS:The concentration of NO in exhaled air was monitored by chemiluminescence in pentobarbital-anesthetized rabbits receiving mechanical ventilatio...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199504000-00021
更新日期:1995-04-01 00:00:00
abstract::Assessment of competency in traditional graduate medical education has been based on observation of clinical care and classroom teaching. In anesthesiology, this has been relatively easy because of the high volume of care provided by residents under the direct observation of faculty in the operating room. With the mov...
journal_title:Anesthesiology
pub_type: 杂志文章,评审
doi:10.1097/01.anes.0000264778.02286.4d
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:The Shannon entropy is a standard measure for the order state of sequences. It quantifies the degree of skew of the distribution of values. Increasing hypnotic drug concentrations increase electroencephalographic amplitude. The probability density function of the amplitude values broadens and flattens, there...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-200107000-00010
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Ventilator-associated pneumonia is a clear risk factor for acute lung injury which has been poorly described in trauma patients. This prospective study was undertaken to estimate the incidence of such ventilator-associated pneumonia leading to acute lung injury, the risk factors, and the associated morbidity...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200602000-00006
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Activation of the complement system is one component of the inflammatory response. Various components of the complement system participate in killing foreign organisms, recruiting immune cells, enhancing edema, and stimulating cytokine formation. Complement-mediated enhancement of the inflammation surroundin...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200606000-00024
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:In the partial CO(2) rebreathing method, monitored changes in CO(2) elimination and end-tidal CO(2) in response to a brief rebreathing period are used to estimate cardiac output. However, dynamic changes in CO(2) production during ischemia and reperfusion may affect the accuracy of these estimates. This stud...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-200308000-00009
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:The authors tested the hypothesis that pretreatment with isoflurane or sevoflurane can protect the heart against neutrophil-induced contractile dysfunction. METHODS:Studies were conducted in buffer-perfused and paced isolated rat hearts. Left ventricular developed pressure served as an index of contractilit...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200403000-00006
更新日期:2004-03-01 00:00:00
abstract::The authors undertook a prospective study of 30 patients undergoing halothane anesthesia for coronary-artery revascularization to ascertain which clinically monitored hemodynamic variables--or combination of variables--associated with myocardial oxygen supply and demand best predict myocardial ischemia. Simultaneous r...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198307000-00007
更新日期:1983-07-01 00:00:00