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Inhalation of ethyl chloride fumes during surgical planing procedures on the face in which that agent is used for local freezing has proved in my hands to be a major disadvantage of this type of anesthetic.
Inability to breathe fresh air free of ethyl chloride fumes frequently causes the patient to hold his breath, to become apprehensive, or even panicky. It frequently limits the extent of the procedure.
To overcome this difficulty I have adopted the use of the following device: The rubber mouthpiece ordinarily used in a BMR machine is fitted with a length of large-size polyethylene tubing. I have found that a length of 4 to 5 in. (10 to 13 cm.) removes the inspired air from the area of concentration of ethyl chloride and does not significantly increase dead air space or resistance to breathing, allowing the patient to ventilate well.
GRAIS ML. PROTECTION AGAINST INHALATION OF FUMES OF ETHYL CHLORIDE DURING SURGICAL PLANING. AMA Arch Derm. 1955;71(3):396. doi:10.1001/archderm.1955.01540270108019
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