When dissection tonsillectomy is performed with the patient in the supine position under general anesthesia with use of a Davis or Tidings type gag, it is customary for the anesthetist to hold the handle of the gag. Unless this is maintained in the optimum position, both the patient's airway and the surgeon's view of the operative field are compromised. Yet holding the gag in this fashion is tiring, and it is not unusual for an anesthetist to exhibit a fatigue-tremor in the hand and forearm after doing several cases on the same day.
In my view, the demands of this purely mechanical task detract from the anesthetist's ability to pay adequate attention to his patient's general condition; when the anesthetist does make adjustments to the anesthesia machine, take blood pressure readings, keep a record, etc., he is likely to move the gag and hinder the surgeon's work.
I have tested
THOMAS DV. A New Gag Support for Dissection Tonsillectomy. AMA Arch Otolaryngol. 1958;67(4):460–461. doi:https://doi.org/10.1001/archotol.1958.00730010472015
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