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Trilene:
It is brand name of
Magill connections:
trichloroethylene. The chemical
These ware curved metal
formula for trichloroethylene was
connectors. The proximal end was
discovered in 1864 by Fischer, and
expanded to facilitate connection
it was popularized as an
with catheter mount. It was
anaesthetic by Langton Hewer in
available in 16 different sizes. Two
1940s. It was a colourless, volatile,
types –oral and nasal connections
non-inflammable, sweet smelling
were available. Nasal Magill
liquid with high lipid solubility. It
connections had sharper curve
was a powerful analgesic and good
while oral Magill connections had
general anaesthetic. It was
gentle curvature and were longer.
decomposed into
Paediatric Magill connection is also
trichloroacetylene and phosgene
displayed beside these.
by soda lime. In 1977 the use of
trichloroethylene as an anaesthetic
was banned by the FDA.
Diethyl Ether: Oxford non-kinking endotracheal
It was prepared by Valerius Cordus tube:
in 1540 and first demonstrated by It is made of red rubber and is
Crawford Long in 1942 and by WTG moulded to form 90O bend inside
Morton in 1846. It is a colourless, the oral cavity. It was used for
pungent smelling, highly orotracheal intubation for
inflammable volatile liquid. It is surgeries in prone or sitting
relatively non-toxic safe and position. It was also sometimes
potent agent. It could be used with used for palate surgery. It needed
open drop method, draw over stylet for insertion and could
technique or in or out of circuit sometimes entered mainstem
vaporizer. Induction of anaesthesia bronchus.
is relatively slow and usually
Clausen’s Harness:
associated with unpleasant stage
of excitement. Recovery is also It is a Y-shaped rubber strap to
slow with prolonged ether keep the face ask in position during
anaesthesia. use. The strapping should be across
the patient’s cheeks and its long
arm is hooked over the top of head.
The straps have holes which are
attached to metal clips around the
connector of face mask. A major
Methoxyflurane: disadvantage was that it took a
Methoxyflurane, a halogen longer time to remove in case of
substituted methyl ethyl ether, vomiting or other airway
was introduced in anaesthesia emergency.
practice by Artusio in 1960. It was
sweet smelling colourless, non-
inflammable, volatile, liquid with
high lipid solubility. It had good
analgesic effect. It had no
interaction with soda lime but was
extensively metabolised and
produced toxic levels of inorganic
fluoride. Fluoride was responsible
for high output renal failure.
Esophageal-tracheal combitube:
Designed by Dr Michael Frass, Dr
Jonas Zahler and Dr Reinhard
Frenzer in 1988 with an aim to
devise an airway which could be
inserted quickly and easily without
a laryngoscope. It is made of two
tubes of unequal length and can be
used for maintaining airway and
ventilation whether its tip is placed
in oesophagus or trachea.
Wright’s Respirometer:
Cole Tracheal Tube:
This respirometer was invented by
The Cole Tracheal Tube was
British physician Dr BM Wright in
introduced by anesthesiologist
1958. It was used by
Frank Cole, M.D. (1909-1982), in
anaesthesiologists or monitoring
1945, when endotracheal
the functioning of anaesthesia
anesthesia in infants and young
ventilators and pulmonary
children was still uncommon.
function of patients, especially in
Narrower tube diameters cause
post-operative period. It can be
more resistance to the flow of air
used to measure volume of expired
through the tube, and can increase
gas during a single breath or during
the work of breathing. Dr. Cole
a given time (for minute
created his endotracheal tube so
ventilation). With use of
that it was narrowest only where it
connectors, it can also be placed on
had to be: through or below the
expiratory limb of breathing
larynx. The portion of the tube that
system to measure tidal volume as
remained above the larynx could
it was sensitive to movement of
be larger in diameter. The part of
gases in one direction only.
the tube with a larger diameter
also helped to prevent the tube
from being inserted too far. In
1957, Dr. Cole proposed a formula
to estimate the best endotracheal
tube size for a pediatric patient. A
modified version of the formula is
still in use today.
Nosworthy connection: Cobb suction Union:
These were two piece metal Cobb suction union is a metallic
connectors. The curved piece was right angled connection with a
connected to catheter mount while removable cap to allow
straight piece was connected to endotracheal suction by removing
endotracheal tube. Its distal end the cap and inserting a suction
varied in size to fit endotracheal catheter into lumen of
tubes of different sizes while endotracheal tube.
proximal end was of standard size.
It allowed rapid disconnection and
reconnection and allowed easy
tracheal suction.
Magill suction Union:
It is also a metallic right angled
Rowbotham connection: connector and has a rubber plug in
This is metal right angled its short projection. This connector
connector. The tapered and also facilitates suction in intubated
serrated end was used to connect patients.
endotracheal tube while the wider
end was connected with catheter
mount. This connector caused
increased resistance to airflow due
Cyprane Trilene Inhaler:
to turbulent airflow.
This was a simple hand held
drawover inhaler designed for use
Fluotec Mk. I Vaporiser: with trilene in 1947 by Cyprane
This was introduced by Cyprane Company. Used mainly for
Company in 1956. It was the first providing analgesia for obstetric
agent specific vaporizer and one of patients and other minor surgical
the first vaporizer to use bimetallic procedures. The device was
strip for temperature attached to a mask and trilene was
compensation. It was recalled inhaled by patient with the device
shortly after introduction as it had in patient’s hands for analgesia. If
a design flaw which could cause too much drug was inhaled, the
the proportioning valve to stick device used to fall from patient’s
thus posing a risk of overdose to hand and preventing overdose.
the patient. It came with a ready This collar of the device could be
reference card indicating the rotated to vary the concentration
vaporizer output at various gas from about 0.22% to 0.54%.
flows.
Barth Three Way Stopcock:
The three-way stopcock shown
Lumbard & Miller Airways
here was introduced by the London
manufacturer, George Barth & Dr. Joseph Lumbard (1865–1942)
Company. The short tube was specialized in anaesthesia at the
connected to a mask that would be turn of the 20th Century. He was an
placed over the patient’s nose and early member of the organization
mouth. The longer tube was that became the American Society
connected to a rubber re-breathing of Anesthesiologists. In 1912, he
bag that would be filled with introduced his "tongue controller"
nitrous oxide gas. airway. This design is open at both
ends. The cage construction makes
The stopcock has three settings
the flexible breathing tube visible
which are controlled by a lever. The
while preventing the patient from
“No Valves” setting allowed the
accidentally biting the tube. In
patient to inhale only from the re-
Europe, the Lumbard airway was
breathing bag, and directed his
sometimes incorrectly called "The
exhaled breath into the bag. Each
Mayo Tube". But in fact Dr.
exhalation added carbon dioxide to
Lumbard worked in New York City,
the gas mixture. The “Valves”
and was not affiliated with the
setting allowed the patient to
Mayo brothers.
inhale only from the bag, while his
exhaled breaths were directed Dr. Albert H. Miller (1872–1959)
away from the bag through a one- was another of the early
way expiration valve. The “Air” specialists. He developed
setting closed off the bag, so that groundbreaking techniques, and
the patient would breathe to and also led several professional
from only the surrounding air. organizations. In 1918-1919, he
served as President of the
American Association of
Anesthetists; this later became the
International Anesthesia Research
Society. In 1918, he modified the
Lumbard airway by wrapping the
cage around the distal end. Both
Lumbard's original design and
Miller's modification of it were
popular for over fifty years.