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September 13, 1913


JAMA. 1913;61(11):838-839. doi:10.1001/jama.1913.04350110020006

Dr. Teter, Miss Hodgins and Miss Toot of Cleveland and Dr. McKesson of Toledo have administered nitrous oxid for surgical purposes over twenty thousand times without a death from anesthesia.

In the hands of the expert nitrous oxid is perhaps the safest known anesthetic, while it is perhaps the least safe in the hands of the inexpert. In equally expert hands ether may rival nitrous oxid as to immediate mortality, but ether is wholly outclassed by nitrous oxid as to the indirect postoperative morbidity and mortality. This striking difference is wholly beyond the control of the anesthetist because it rests on a chemical basis. The chemical reactions which favor nitrous oxid anesthesia and handicap ether anesthesia are the following: Nitrous oxid produces anesthesia by reason of its interference with the use of oxygen by the brain-cells; it apparently exerts no other influence except this oxygen interference; therefore its total effect

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