Collected Papers By the Staff of Saint Mary's Hospital, Mayo Clinic 6
Collected Papers By the Staff of Saint Mary's Hospital, Mayo Clinic 6
Saint Marys Hospital (Rochester, Minn.)
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In the more serious cases, with broken compensation, renal changes, etc., great care is necessary in the selection and conduction of the opera- tion. In some instances it seems advisable to carry out the entire operation under local anesthesia; in others ether throughout is the method most suitable, while yet in others a combination of the two anesthetics is the most satisfactory. Not only the general condition, but the type of the patient, plays a large part in the decision of what should be d...one. One may be little disturbed by n thyroidectomy under local anesthesia, while another, apparently in a similar physical condition, may be rebellious, and any attempt to carry out the operation under local anesthesia may be ex- tremely dangerous. Many of these patients have reached a state of exhaustion, and about the limit of cardiovascular stimulation, and any slight extra exertion may prove fatal. This group derives little if any benefit from preparatory opera- tive treatment. Any attempt to cut off part of the circulation by ligation of vessels is not followed by beneficent results, and is SUMMARY OF OUR PRESENT KNOWLEDGE OF GOITER 375 especially futile in the single adenomas.
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