Somerson S J
AANA J. 1990 Aug;58(4):288-95.
Contemporary interest in resuscitation was historically related to anesthetic death. Primitive techniques of anesthetic administration, loss of airway control, and psychologically influenced sudden death contributed to unanticipated respiratory and cardiac arrest. Airway obstruction has remained the principal factor in asphyxial death, necessitating crucial preservation of respiratory function during induction of anesthesia. Early, disorganized overdose and arrest interventions included: application of cold water, manual artificial respiration, heat, friction and galvanic battery application. Cardiopulmonary resuscitation, after years of research and experimentation became an integrated plan of attack: mouth-to-mouth ventilation and maneuvers eliminating pharyngeal obstruction were proven effective; internal and external cardiac massage was incorporated and definitive drug therapy began with epinephrine, strychnine, caffeine, carbon dioxide, amyl nitrate, coramine, metrazol and procaine. Defibrillation proved electricity converted ventricular fibrillation to normal sinus rhythm. Significant lethality still occurs from anesthetic-induced cardiac arrest, despite technological advances. Causes of operating room cardiac arrests are numerous and include sudden death syndrome. Constant vigilance distinguishes variable patient response. Immediate recognition and coordinated intervention assures success.
当代对复苏的关注在历史上与麻醉死亡有关。原始的麻醉给药技术、气道控制丧失以及心理因素导致的猝死，都促成了意外的呼吸和心脏骤停。气道阻塞一直是窒息死亡的主要因素，因此在麻醉诱导期间保持呼吸功能至关重要。早期混乱的过量用药和骤停干预措施包括：应用冷水、人工手动呼吸、热敷、摩擦和使用电池。经过多年的研究和试验，心肺复苏成为了一套综合的急救方案：口对口通气和消除咽部阻塞的操作被证明是有效的；纳入了胸外和胸内心脏按压，并且确定了以肾上腺素、士的宁、咖啡因、二氧化碳、亚硝酸异戊酯、可拉明、戊四氮和普鲁卡因开始的药物治疗。除颤证明电可将心室颤动转换为正常窦性心律。尽管技术有所进步，但麻醉引起的心脏骤停仍会导致相当高的死亡率。手术室心脏骤停的原因众多，包括猝死综合征。持续的警惕能区分不同患者的反应。立即识别并进行协调干预可确保成功。
