Harold Griffith: Difference between revisions
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The dose of curare was not a minute homeopathic quantity that would produce symptoms of the patient's problem; the surgery might well be for a broken hip, which would not interfere with respiration. It was a dose that overwhelmed muscles and nerves, but with a self-limiting effects. The drug effects were not "like curing like" in homeopathic terms, but adjuncts to the curative surgery. | The dose of curare was not a minute homeopathic quantity that would produce symptoms of the patient's problem; the surgery might well be for a broken hip, which would not interfere with respiration. It was a dose that overwhelmed muscles and nerves, but with a self-limiting effects. The drug effects were not "like curing like" in homeopathic terms, but adjuncts to the curative surgery. | ||
The first neuromuscular blocking agents, such as [[tubocurarine]], took a long time to clear after surgery, and new, shorter agents such as [[rocuronium]] are used so that the patient can recover faster from the effects of either natural preparations, or drugs used with limited knowledge of the structure-activity relationships between their molecular structure and the appropriate cellular receptors. Additional families of paralyzing agents, such as [[succinylcholine]], emerged. In the urgent procedure of [[rapid tracheal intubation]], a series of drugs, typically including two different families of blocking agents, operate on different molecular receptors. | The first neuromuscular blocking agents, such as [[tubocurarine]] (one of the natural curare constituents), took a long time to clear after surgery, and new, shorter agents such as [[rocuronium]] are used so that the patient can recover faster from the effects of either natural preparations, or drugs used with limited knowledge of the structure-activity relationships between their molecular structure and the appropriate cellular receptors. Additional families of paralyzing agents, such as [[succinylcholine]], emerged. In the urgent procedure of [[rapid tracheal intubation]], a series of drugs, typically including two different families of blocking agents, operate on different molecular receptors. | ||
Revision as of 12:39, 2 October 2008
Template:TOC-right Harold Randall Griffith,MD, CM, OC (1894-1985) was a distinguished Canadian anesthesiologist, trained in both conventional medicine and homeopathy. Among his contributions to anesthesia, for which he is responsible, is the introduction of total skeletal muscle relaxation, as well as the use of safer inhaled anesthetics. Inhaled and other general anesthetics depress the brain, heart, and other systems, and, while total relaxation is indeed necessary for some surgery, before the advent of muscle paralyzing drugs, the only way to get it was with a near-fatal dose of anesthetic.
The use of curare vastly lowered the anesthetic dosage needed for safe surgery, so he improved patients' outcomes both with introducing safer drugs, and demonstrating a way that requires lesser quantities of them.
Curare, made obsolete by synthetic neuromuscular blocking agents that are synthesized based on principles of molecular pharmacology, was used as an arrow poison by South American natives to paralyze game. With no further interventions, curare would kill those food animals, because among the muscles it paralyzes are those required for breathing. It could not be used surgically until respiratory physiology and ventilator design had advanced to a point where the anesthesiologist could keep oxygen flowing to the patient, or the patient would asphyxiate as surely as a game animal struck by a poisoned error.
The dose of curare was not a minute homeopathic quantity that would produce symptoms of the patient's problem; the surgery might well be for a broken hip, which would not interfere with respiration. It was a dose that overwhelmed muscles and nerves, but with a self-limiting effects. The drug effects were not "like curing like" in homeopathic terms, but adjuncts to the curative surgery.
The first neuromuscular blocking agents, such as tubocurarine (one of the natural curare constituents), took a long time to clear after surgery, and new, shorter agents such as rocuronium are used so that the patient can recover faster from the effects of either natural preparations, or drugs used with limited knowledge of the structure-activity relationships between their molecular structure and the appropriate cellular receptors. Additional families of paralyzing agents, such as succinylcholine, emerged. In the urgent procedure of rapid tracheal intubation, a series of drugs, typically including two different families of blocking agents, operate on different molecular receptors.