IN OPHTHALMOLOGIC and otolaryngologic surgery one encounters some of the most difficult procedures in anesthesia. This is particularly true if the requirements of the patient, the surgeon, and the anesthesiologist are to be satisfied. Regional analgesia may be employed satisfactorily for short superficial procedures, since the patient will usually tolerate an uncomfortable position as well as manipulation discomforts for limited periods. However, during long and/or tedious procedures requiring deep manipulations of the face, nasal pharynx, oral pharynx, pharynx, larynx, or trachea, the constant cooperation of the patient must not be relied on. Restlessness and motion at a crucial point by a patient who was thought to be cooperative may prove disastrous to the patient or to the operative result being sought. Likewise, the administration of an intravenous, rectal, or inhalation anesthetic to a patient in whom regional analgesia was started and whose airway has been made inaccessible by the drapes
MOORE DC, TOLAN JF. ANESTHESIA FOR LONG OR TECHNICALLY DIFFICULT OPHTHALMOLOGIC AND OTOLARYNGOLOGIC SURGICAL PROCEDURES. AMA Arch Otolaryngol. 1952;55(3):350–362. doi:10.1001/archotol.1952.00710010360006
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