Word: anesthesiologists
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That was where Anesthesiologist Kenneth Keown came in. He devised elaborate techniques for anesthetizing the patients and running sensitive tests during surgery to make suwf that they did not slip over the line into permanent oblivion. If their hearts, at best always on the point of failure, showed signs of stopping during the drastic operation, Dr. Keown was ready with a battery of revivers. The surgeon would work better without the nagging fear and responsibility for the patient's minute-to-minute reactions. The Hahnemann team's technique has already saved thousands of lives and is becoming standard...
...adaptation of Dr. Keown's technique, surgical teams at the University of Illinois hospitals have performed 200 operations on the mitral valve without a single death in the operating room (and few deaths afterward). Dr. Sadove reported. Then he spelled out the dozens of delicate steps which the anesthesiologist takes in each such case. The key steps give a good idea of how far anesthesiology has advanced beyond the mask-and-needle stage...
Ether is put through the tube to produce deep anesthesia. (Oxygen is still being given.) If the pulse rate drops below 60, the anesthesiologist injects atropine. Procaine is injected into the rib cage and around the heart, and, finally, as the surgeon lays the heart bare, into the heart itself. Only then is the actual operation of widening the valve performed. The anesthesiologist injects lidocaine to block the nerves of the rib cage. As the wound is being closed, he twirls the knobs on the anesthesia machine to give a mixture of nitrous oxide and oxygen. The patient...
...great a challenge as those inside the heart. But, in Dr. Sadove's view, the distinction between major and minor surgery disappears when anesthesia is employed, because anesthetics are such powerful and dangerous substances that their every use is a major medical event. That is why the anesthesiologist is called in on the case early, perhaps to help the internist and surgeon decide whether an operation is feasible. That is why, during the operation, the anesthesiologist is responsible for the patient's general welfare, beyond the immediate area where the surgeon is working-and if he says...
...greatest problems of heart surgery have cemented the relationship between surgeons and anesthesiologists so that now they tend to work more closely in many other types of cases. Dr. Sadove, who spent four wartime years in U.S. Army hospitals in England, likes to use a military metaphor: "The small-arms fire of the anesthesiologist joins the spy system of the lab to back up the surgeon's big artillery in a coordinated attack to conquer disease...