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March 5, 1955


JAMA. 1955;157(10):843-844. doi:10.1001/jama.1955.02950270061021

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To the Editor:—  Dr. Amos R. Koontz, in a letter to the Editor in The Journal of Dec. 25, 1954, page 1628, discusses poor cooperation between the anesthetist and the surgeon to the detriment of the patient. The gist of his argument is that violent postoperative struggling due to tracheobronchial suction or pain in a patient inadequately protected by anesthesia or analgesics may be disastrous to the suture line. According to Dr. Koontz, this is the time when incisional hernias develop, not later in the postoperative period.The conscientious and well-trained medical anesthesiologist is just as anxious to help in the cure of the surgical patient as is the surgeon. His role is to expedite surgical manipulations, and often he must produce conditions of anesthesia that are distinctly harmful to the patient, using depths or agents which may not be necessary for other surgeons. Time is a vital factor as

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