chapter18

chapter18 - 18: Ethers and Epoxides; Thiols and Sulfides...

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Unformatted text preview: 18: Ethers and Epoxides; Thiols and Sulfides Based on McMurrys Organic Chemistry , 7 th edition 2 Common Ethers Common Ethers Commonly referred to as simply ether, used as an Commonly referred to as simply ether, used as an anesthetic, solvent, cold start fuel. anesthetic, solvent, cold start fuel. 3 Pre-Anesthesia Pre-Anesthesia Surgery was a last and desperate resort. Reminiscing in 1897 about pre-anesthesia surgery, one elderly Boston physician could only compare it to the Spanish Inquisition . He recalled yells and screams, most horrible in my memory now , even after an interval of so many years. Over the centuries, numerous techniques had been used to dull sensation for surgery. Soporifics [sleep-inducing and awareness-dulling agents] and narcotics were prepared from a wide range of plants, including marijuana, belladonna and jimsonweed. Healers attempted to induce a psychological state of anesthesia by mesmerism or hypnosis . Distraction could be provided by rubbing the patient with counterirritants such as stinging nettles. A direct but crude way of inducing a state of insensitivity was to knock the patient unconscious with a blow to the jaw . But by 1846, opium and alcohol were the only agents which continued to be regarded as of practical value in diminishing the pain of operations. Unfortunately, the large doses of alcohol needed to produce stupefaction were likely to cause nausea, vomiting and death instead of sleep. 4 Ether Day Monday, Oct. 29, 1923 The 77th Anniversary of the first public demonstration of the use of ether ansthesia in surgery was celebrated at the Massachusetts General Hospital, Boston. It was there, on Oct. 16, 1846, that Dr. William T. G. Morton (1819-1868), then a young dentist studying medicine, ansthetized a patient with ethyl ether, while Dr. Warren, senior surgeon, removed a tumor from the patients neck. Others (Long, 1842, Robinson, Liston, Jackson) have disputed with Morton priority in the use of ether, but the consensus of medical opinion has awarded him the honor. Upon wakening, the patient informed the curious and skeptical physicians and medical students in the theater that he had experienced no pain. . THE ETHER DOME THE ETHER DOME 5 How Does Ether Work as an How Does Ether Work as an Anesthetic? Anesthetic? The brain, being mostly fat, absorbs a lot of the ether agent from the blood . Many theories have been considered to explain how anaesthesia is produced. One suggests that the fat in the cell wall swells up . This reduces the ability of the nerves to conduct impulses to each other and activity is reduced, or stopped altogether if you give an overdose. Fortunately, the higher centres controlling consciousness are the first affected and the vital centres such as the respiratory and vasomotor centres are more resistant to this effect. Thus we take it almost for granted that the anaesthetised patient will go on breathing with a near-normal pulse and blood pressure. 6...
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chapter18 - 18: Ethers and Epoxides; Thiols and Sulfides...

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