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March 23, 1963

Concepts in Anesthesiology

JAMA. 1963;183(12):1051. doi:10.1001/jama.1963.03700120109023

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To the Editor:  —Dr. Vincent J. Collins' recent address to the Section on Anesthesiology of the American Medical Association [published JAMA182:105] is worthy of some comment and criticism.The over-all picture defining the scope and ever-increasing responsibilities of the anesthesiologist has been well covered. Another item mentioned but perhaps not stressed sufficiently concerned operating time. There is a great misconception, prevalent in surgical spheres, that with modern anesthesia the patient is not harmed by prolonged manipulations in the operating room. This is not true. Every extra minute geometrically increases the hazard. The death of a patient who suffers a cardiac standstill after an operation of three hours, which could have been equally well done in two, is preventable.The truth of the well-known statement by Dr. John Gillies, referring to anesthetic management as "physiological trespass" cannot be denied.Whatever skill and experience we possess is dedicated to the

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