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August 10, 1946


Author Affiliations

Detroit. Professor of Anesthesiology, Wayne University College of Medicine.

JAMA. 1946;131(15):1241. doi:10.1001/jama.1946.02870320059023

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To the Editor:—  The editorial on the "Use of Fowler's Position in Surgery" in the July 6 issue should be particularly helpful to anesthesiologists. It has been a constant struggle to prevent nurses, interns and other members of the surgical staffs from elevating patients' heads too soon after anesthesia.I should like to add to the reasons put forth against the routine use of this position. Most types of general anesthetic drugs depress the normal activity of the autonomic nervous system which provides proper control of the circulatory system so necessary in the upright or semiupright position. This depression may continue for a few hours after the patient has returned to bed. Even after full return of consciousness many patients will have a drop in blood pressure from elevation of the head. This I have witnessed many times, and placing the patient in the horizontal position resulted in return of

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