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January 14, 1956


JAMA. 1956;160(2):135. doi:10.1001/jama.1956.02960370045016

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To the Editor:—  During transurethral surgery performed under thiopental (Pentothal) sodium-nitrous oxide-curare anesthesia, the anesthesiologist noticed a sparking sound accompanying each electrical manipulation, the smell of burning rubber, and the appearance of smoke. A few moments later, sparks were seen to pass from the operating table to one of the breathing tubes, where it lay across the painted metal edge of the table; the rubber breathing tube was later found to have been burned but not perforated. The anesthesia machine was immediately pushed away from the operating table and the anesthesia system converted from thiopental-nitrous oxide to thiopental-air. It was quickly found that the wire grounding the operating table was not making proper metallic contact with the ground pipe. The electric charge on the table therefore mounted, and finding intermittent contact with the conductive rubber breathing tube, the anesthesia machine and the tube became converted into a sort of ground;

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