The operating room and the patient; a manual of pre- and post-operative treatment . y must be raised by the mitiga-tion of the sepsis, nephritis, and intestinal stasis with portalplethora. Having prepared a patient for the narcosis, the next step is tosee that he is properly placed (Fig. 113) on the table for theoperation. Place an ordinary surcingle snugly around the tableand patients legs just above the knees, have the shoulder sup- ANESTHESIA 139 ports well padded and in place ready for the Trendelenburg orprostatectomy position, the arms at the side, palms down, wellunder the buttocks or f
The operating room and the patient; a manual of pre- and post-operative treatment . y must be raised by the mitiga-tion of the sepsis, nephritis, and intestinal stasis with portalplethora. Having prepared a patient for the narcosis, the next step is tosee that he is properly placed (Fig. 113) on the table for theoperation. Place an ordinary surcingle snugly around the tableand patients legs just above the knees, have the shoulder sup- ANESTHESIA 139 ports well padded and in place ready for the Trendelenburg orprostatectomy position, the arms at the side, palms down, wellunder the buttocks or folded across the chest and fastened witha broad soft roller of gauze around the forearms from wrist toelbow. In cases for gastric, gall-bladder or kidney work thekidney bridge of the operating table should be properly situatedunder the part to be elevated so that no later change of positionwill be necessary. In all cases where nitrous oxid is to be theanesthetic the patient should be placed in position before theanesthetic is begun; especially is this true of the lithotomy posi-. Fig. 113.—Patient in position for anesthesia. tion, for spasm of the limbs is common even with deep cases for thyroidectomy the trunk is best elevated to an angleof thirty-five degrees with the legs and the head dropped backas far as possible without interfering with breathing. In brainsurgery the Gushing or other head rest is placed in positionbefore the final preparation for operation. The use of preliminary medication in the form of mo-rphin,scopolamin, pantopon, chlorotone, etc., has an important bear-ing on the initiation of the anesthesia as well as the general sur-gical aspect of the case immediately post-operative. Except inthe aged, the very young, and these patients in whom septicemia,anemia or other diseased conditions have already done whatmorphin and scopolamin do, namely, depressed the associationalpower of the brain, the preliminary use of sedative medicationis distinctly i
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