Firth Paul G
From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Ann Surg Open. 2022 May 17;3(2):e166. doi: 10.1097/AS9.0000000000000166. eCollection 2022 Jun.
The details of the public demonstration of the effects of ether that initiated the modern era of surgery and anesthesia are often misreported. Existing published transcripts of the clinical records are incomplete or inaccurate.
The patient notes of Gilbert Abbott were photographed, transcribed, and reviewed.
The records are handwritten in "Surgical Records for 1846; Volume 30," of the Massachusetts General Hospital. The patient was admitted on September 25. The presenting condition was a congenital, mobile, compressible, multilobed, small lesion at the angle of the left mandible, and base of tongue. The operation on October 16 was an attempted ligation of the blood supply to the lesion. The postoperative diagnosis was a vascular lesion ("erectile tumor"). Postoperative management included application of sclerosants. The mass was unchanged in size on discharge on December 7. There is no documentation of the anesthetic administration in the progress note but a retrospective report of the anesthetic is pasted into the Records book. This account reported that the patient did not respond to the initial incision. He moved and cried out during the latter part of the procedure. Although he was aware of the operation taking place, he later said he had not experienced pain. The commentary concluded that the demonstration of the analgesic effectiveness of ether was inconclusive but that subsequently ether was shown to be effective.
The surgery on October 16, an unsuccessful ligation of a congenital lymphovascular malformation, was performed under incomplete general anesthesia. Examination of the primary documents may allow for more accurate accounts of circumstances surrounding the discovery of anesthesia.
开启现代外科手术和麻醉时代的乙醚效果公开演示的细节常被错误报道。现有的已发表临床记录抄本不完整或不准确。
对吉尔伯特·阿博特的患者记录进行拍照、转录并审阅。
这些记录手写于马萨诸塞州总医院的《1846年外科记录；第30卷》中。患者于9月25日入院。就诊情况为左下颌角和舌根处有一个先天性、可活动、可压缩、多叶的小病变。10月16日的手术是试图结扎病变的供血血管。术后诊断为血管病变（“勃起性肿瘤”）。术后处理包括应用硬化剂。12月7日出院时肿块大小未变。病程记录中没有麻醉用药的记录，但一份麻醉回顾报告粘贴在了记录册中。这份报告称患者对最初的切口没有反应。在手术后期他动了并且叫了出来。尽管他知道手术在进行，但他后来表示自己没有感到疼痛。评论总结说，乙醚镇痛效果的演示尚无定论，但随后显示乙醚是有效的。
10月16日的手术是对先天性淋巴管畸形进行的结扎术，手术未成功，是在不完全全身麻醉下进行的。对原始文件的审查可能会使人们对麻醉发现时的相关情况有更准确的描述。
