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The Doctor Who Vanquishes Pain In an age of medical specialities, the anaesthesiologist is a specialist in the
use of drugs to prevent suffering. The pain of surgery is his first concern.
as it has been for more than a hundred years. The anaesthesiologist also
brings swift relief to accident victims, treats ailments of the respiratory
tract and eases the agony of incurable diseases. He draws on an extensive
range of instruments and drugs: machines that temporarily substitute
for body organs, gases that can induce a dreamy doze or deep unconsciousness, tranquillizers that banish fear, injections that block pain. So precise
is the control afforded by these new tools and techniques that the anaesthesiologist can, in effect, suspend life for hours at a time, making possible
some of the most dramatic achievements of modern surgery, such as the
repair of a damaged heart or the replacement of a diseased kidney.
In 1842, an American physician named Crawford Long made medical
history when he held an ether-soaked towel over a patient's face until he
was unconscious. Then Dr Long removed a small neck tumour; the patient
experienced no pain. It was the first successful use of surgical anaesthesia.
Today ether-obtained by distilling ethylene with sulphuric acid -- remains one of the most effective drugs for inducing the deep, relaxed
sleep required for major surgery. But ether has an unpleasant, often
nauseating odour; it irritates the respiratory system and it is dangerous
to use because of its explosive nature. In one method of overcoming these
drawbacks anaesthesiologists use only very small amounts of ether, often
mixed with another anaesthetic, as the finishing touch in a step-by-step
procedure for inducing sleep. This technique, tailored to the individual,
employs a series of drugs designed to achieve successively deeper
anaesthesia.
In a typical procedure, a pleasant relaxation is induced by injections
of scopolamine and morphine. Calm and relaxed, the patient is now ready
for an intravenous injection of sodium pentothal that will bring on the
first stage of anaesthesia, a light doze, followed by the second stage, loss
of consciousness and dulling of the brain's pain response. The third stage,
complete unconsciousness, generally requires some drug as strong as ether.
The anaesthesiologist inserts a plastic tube into the trachea, or windpipe,
so that a mixture of ether, nitrous oxide and oxygen can be fed directly into
the lungs without irritating the breathing passage. Only when he is certain
that the patient's central nervous system is completely insensitive to pain
will the anaesthesiologist give the quick nod that indicates the operation
may begin.
Once surgery has begun, the anaesthesiologist becomes the watch-dog
of the operating room, the man responsible for keeping the unconscious
patient alive. Keeping an eye on the work of the surgeon, the anaesthesiologist concentrates on changes in the patient's blood pressure, pulse
and breathing. He checks to see that the anaesthetic gas mixture contains
28 to 30 per cent oxygen, for even a brief drop-off may cause asphyxiation.
He examines the patient's eyes for subtle changes that mean the anaesthetic
is wearing off or that it is sinking the patient into a dangerously deep sleep.
After surgery is completed the anaesthesiologist faces one of his most
difficult tasks: he must restore his anaesthetized patient to complete
consciousness as smoothly and painlessly as possible. The best drug for
this purpose is oxygen. Flooding into the lungs, oxygen forces the anaesthetic gases out of the patient's body and also eases the work of the heart
and respiratory system as the patient awakens.
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1. |
From the passage we can gather that the use of anaesthesia has existed |
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(A) |
for a hundred years. |
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(B) |
for more than a century. |
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(C) |
for less than a century. |
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(D) |
only since the beginning of this century. |
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2. |
An anaesthesiologist's main concern is to |
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(A) |
relieve the pain of accident victims. |
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(B) |
treat patients suffering from incurable diseases. |
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(C) |
ease the pain of surgery. |
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(D) |
administer pain-relieving drugs. |
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3. |
What actually makes it possible for surgeon to perform the amazing feats of
modern surgery ? |
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(A) |
It is the use of machines which are substitutes for body organs. |
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(B) |
It is the drugs which block pain and tranquillizers which banish fear. |
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(C) |
It is the gases which induce a dreamy sleep or deep unconsciousness. |
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(D) |
It is the precise control exercised by the anaesthesiologist by means of
new instruments and techniques. |
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4. |
Which of the following statements about ether is false ? |
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(A) |
It has an unpleasant smell. |
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(B) |
It is explosive in nature. |
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(C) |
It is an effective drug for rendering a patient completely unconscious. |
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(D) |
It is used in large amounts to achieve anaesthesia. |
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5. |
In the first stage of anaesthesia the
patient is |
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(A) |
completely unconscious. |
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(B) |
in a coma. |
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(C) |
in a light sleep. |
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(D) |
in a sound sleep. |
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6. |
When does the surgeon begin the operation ? |
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(A) |
He does so when the patient is calm and relaxed. |
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(B) |
He does so when the patient's central nervous system is
completely insensitive. |
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(C) |
He does so when the patient has lost consciousness. |
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(D) |
He does so when the patient's pain response has been
dulled. |
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7. |
Which of the following statements about the
anaesthesiologist is false ? |
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(A) |
He prepares the patient for the operation. |
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(B) |
He sees to it that the patient is not asphyxiated during
the operation. |
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(C) |
He monitors the patient's heartbeats and breathing. |
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(D) |
His duties are over when the operation is completed. |
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8. |
Nowadays, in order to induce the complete
insensitivity to pain necessary for major surgery, the anaesthesiologist
uses |
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(A) |
a mixture of ether, nitrous oxide and oxygen. |
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(B) |
scopolamine and morphine. |
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(C) |
sodium pentothal. |
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(D) |
all of the above at different stages. |
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9. |
The anaesthetic gas mixture is usually |
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(A) |
fed straight to the lungs through the trachea. |
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(B) |
breathed in by the patient. |
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(C) |
injected into the lungs. |
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(D) |
fed to the lungs through a plastic tube. |
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10. |
Which of these statements is false ? |
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(A) |
The anaesthesiologist is a specialist in relieving the
pain of surgery and sickness. |
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(B) |
Without the expertise of the anaesthesiologist, the
achievements of modern surgery would be impossible. |
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(C) |
Once of the most effective drugs used by the
anaesthesiologist in his job is ether. |
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(D) |
The anaesthetic gas mixture contains mainly ether, with
some nitrous oxide and oxygen. |
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