William D. Haggard
1908 Journal of the American Medical Association  
This is obtained by several different apparatus (Clover's, Hewitt's, Bennett's Pedersen's and others), by which nitrous oxid is given until narcosis is obtained, then followed by ether vapor and nitrous oxid, then continued with ether vapor and air. It is necessary for the gas-ether apparatus to employ the aid of anoxemia by the use of a rebreathing bag to maintain a narcosis between the discontinuance of the gas and until the state of complete etherization is obtained. It is necessary to
more » ... necessary to discontinue the administration of the gas early because of the asphyxiation which would follow otherwise. Advantages.-1. Since narcosis is produced first by gas, the odor of the ether and distress of the induction period is abrogated. Thirty seconds is usually sufficient to produce nitrous oxid narcosis. Surgical ether anesthesia is obtained in from two and one-half to four minutes. 3. Statistics show that the gas-ether sequence is much safer than the administration of ether alone. This is probably due to the elimination of the stage of excitement which is the most dangerous stage of anesthesia. 4. A small amount of ether is necessary to continue anesthesia because of the rebreathing of this method. Disadvantages.-1. It requires considerable skill for its administration. 2. The cyanosis from the gas and the clonic spasms which sometimes follow is, perhaps, free from danger, but is frightening to those unaccustomed to its use. 3. The rebreathing is objectionable for reasons stated
doi:10.1001/jama.1908.25410190014001f fatcat:am5v7vqzxfbt5mwzhixuozzfoe