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March 20, 1943


Author Affiliations


From the Anesthesia Service at the Massachusetts General Hospital and the Anesthesia Laboratory of the Harvard Medical School at the Massachusetts General Hospital.

JAMA. 1943;121(12):899-903. doi:10.1001/jama.1943.02840120001001

The relationship of anesthesia to shock is a particularly close one in military surgery, not only because of the frequency of the appearance of shock in warfare but also because anesthesia can be and often is the precipitating factor in the development of shock. Anesthesia can knock down the body's defenses and transform a compensated circulatory system into an inadequate one, with the result that profound shock appears in an individual previously not in shock. Several mechanisms which function in this way are fairly well understood and, although interesting, can scarcely be discussed here in detail, for my aim in this report is to set forth as clearly and as briefly as possible the considerations which determine acceptability or unsuitability of the common anesthetic agents for use in those who are seriously wounded. Emphasis is given to agents and technics which are suitable for use under circumstances of mobile warfare.