The use of avertin for the production of basal narcosis in children.

The introduction of avertin has been described as the most important discovery in anaesthesia for many years1, and one of the greatest of the benefits which it confers is the complete amnesia provided by this substance for children about to be submitted to the otherwise terrifying orde'al of inhalation anaesthesia. All observers are agreed that the psychological trauma inflicted on the patient by the ordeal of an operation is naturally greater in the case of children than in the majority of adults. The attendant circumstances of the induction of inhalation anaesthesiai are obviously the cause, this being the only part of the proceedings of which the patient is conscious. This psychological trauma may be hidden, but it is soon apparent when-sometimes many years later-a child becomes aware that it is again to be subjected to the induction of inhalation anaesthesia. An anaesthetist witnesse5 few scenes more disturbing to all concerned than the abject terror so often displayed by the unfortunate child in these circumstances. Before the introduction of basal narcosis, the child was frequently submitted to the ordeal of being suddenly taken from his accustomed ward and confronted with the strange surroundings and strange faces in the anteroom of the theatre, followed by varying degrees of apprehension until he received the crowning horror of feeling suffocated by the anaesthetic mask placed over his face. The introduction of basal narcosis by means of methods both reliable and safe has made it possible entirely to abolish this undesirable accompaniment of operation. It is, in fact, hardly an overstatement to say that, excepting in case of urgency, or other exceptional circumstances, no conscious child should ever see the theatre or be submitted to the terrors associated with thd induction of inhalation anaesthesia.