Article

Methoxyflurane: A Clinical Evaluation of its Effects, Based on Five Hundred Cases

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Abstract

METHOXYFLURANE, the nonflammable anesthetic agent, has been administered to more than 2000 patients at the Cleveland Clinic Hospital. Wasmuth and associates1 reported a clinical evaluation of the use in 206 cases; our report is an evaluation of 500 additional consecutive cases from near the end of the series. The cases are an unselected series comprising various operative procedures (Table 1). The ages of the patients ranged from 6 months to 74 years, the mean age being 45 years; the ages of 50 patients (10 per cent) ranged from 6 months to 14 years.

Technic of Administration

Methoxyflurane was administered in one of two ways: by vaporization in a No. 8 Heidbrink wick vaporizer, or by open-drop technic. The semiclosed and closed technics were used. The majority of anesthetics were administered with the No. 8 Heidbrink wick vaporizer.

The patients were premedicated either with morphine sulfate or with meperidine hydrochloride, atropine, and a barbiturate. In most cases intubation was used after a thiopental sodium—succinylcholine—oxygen sequence. The volume of gas flow was in most cases 4 1., utilizing 2-1. volumes of nitrous oxide and oxygen. The vaporizer was opened to the first, or number 1 position, and then was rather rapidly advanced to the number 5 or number 6 position. If the patient were allowed to breathe spontaneously, the induction would be prolonged. However, when the respirations were assisted, a plane of surgical anesthesia could be reached within 10 minutes, as evidenced by a gradual fall in blood pressure. . .


 

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