PRELIMINARY ARTIFICIAL PNEUMOTHORAX IN OPERATIONS ON THE OPEN CHEST

Abstract

If the silence of the last ten or fifteen years is an index, it may be assumed that the question of anesthesia in operations on the chest has been solved satisfactorily. This is true for most of the operations surgeons are called on to perform. Procaine hydrochloride, aided occasionally if not regularly by a light nitrous oxide narcosis or a few whiffs of ethyl chloride, gives a satisfactory anesthesia for extrapleural operations—thoracoplasty, avulsion of the phrenic nerve, extrapleural operations on the esophagus and also for more or less extensive thoracotomies when the lung is fixed by a thick and rigid pleura. Local anesthesia with or without nitrous oxide is also satisfactory in that type of operation which we have been led by Evarts Graham to use in suppurative disease of the lung: chronic abscess, chronic suppurative pneumonia and bronchiectasis—a type in which the lung is entered after it has