'Vomiting and nausea are extremely rare and seldom last more than a few hours. Generally children tolerate fluid food a few hours after the operation, unless there are pains that deprive them of their appetite.
Children should be protected from becoming cold during anesthesia, and only the necessary parts of their body should be exposed. The temperature of the operating room should not be below 24° C. (75,2° F.). Warm coverings should he applied after the operation to compensate for the loss of body heat during the operation.
It should never be forgotten that a child's body is more rapidly cooled than that of the adult (catching cold).
The air in the sick room should be frequently renewed as long as the child's breath smells of ether.
If anesthesia is carried out in this manner, there should be no unpleasant results. I have never seen arrest of respiration, with follow ing artificial respiration and its accompanying exciting scenes and great imperilling of asepsis, since the exclusive use of ether, while in chloro form anesthesia this was no unusual occurrence. Slight rise of tem perature on the day of operation, attributable to bronchitis, has occa sionally been observed, but we have never lost a life, while deaths not infrequently occur from the condition of collapse incidental to chloro form anesthesia.
One single exception should be made in the ease of older children with cleft palate, who are kept quiet under ether only with difficulty. Here anaesthesia, after having been commenced with ether, may be deepened by a few drops of chloroform.
Lumbar anmsthesia, in spite of the easier execution of lumbar punc ture in children, should never be employed.
Local ancesthcsia becomes more important the older the child and the more it is possible to count upon his intelligence.
Ethyl chloride and infiltration by the Schleieh and other methods may be used in many conditions (resection of ribs, struma, skin opera lions), but due regard must always be paid to the tenderness of the skin skin necrosis in the newborn after using Mime).
1 use the one-half to One per cent. novoeaine solution proposed by Bier, which I prefer to the other solutions on account of its greater simplicity.
Conduction anasilicsia by interrupting the nerve conduction, fol lowing Braun, especially when combined with a few drops of one per cent. adrenalin solution, admits of extended application of local thesia which renders excellent service especially in operations on the extremities and in plastic skin operations.