During the past twenty years there has been a rapid evolution in anaesthesia, so much so, that we stand on the brink of a major change in the role of the anaesthetist in medicine. Anaesthesia has now emerged from being a craft speciality, obsessed with details of techniques, to become a science concerned with the maintenance of life. As a result of our better understanding of the physiological and pharmacological effects of anaesthesia and surgery, new opportunities have been created for anaesthetists to apply their particular knowledge, not only to provide better and safer conditions for surgery, but also in resuscitation, ventilatory and circulatory support and in the treatment of chronic pain. This has resulted in the recognition of the anaesthetist as a physician specialising in applied physiology and clinical pharmacology. The 1971 Boerhaave Course in Anaesthesia has deliberately tried to reflect this scientific basis of the speciality of anaesthesia by selecting for presenta tion in this book, subjects in which recent investigations have provoked new concepts and ideas. We are most grateful to our colleagues who presented a paper and to the secretary-staffs of our departments of anaesthesia in Leiden and London. Also thanks are extended to Mrs. Bongertman for the preparation of the proofs. Department of Anaesthesiology 10han Spierdijk University Hospital, Leiden Department of Anaesthetics Stanley Feldman Westminster Hospital, London v CONTENTS Preface . . . V Contributors . VIII PART ONE ANAESTHESIA AND THE HEART Alpha and beta blockers in anaesthesia . 3 H. LABORIT 18 Advantages and disadvantages of isoprenaline .

Inhalt
One Anaesthesia and the Heart.- Alpha and beta blockers in anaesthesia.- Advantages and disadvantages of isoprenaline.- Use and misuse of oxygen.- The anaesthetic management of the surgical patient with a cardiac pacemaker.- Two Muscle Relaxants.- New concepts of the action of muscle relaxants.- The action of muscle relaxants of cholinergic mechanisms in the heart.- Changes of acid-base balance and muscle relaxants.- The use of muscle relaxants in anephric patients.- Three Effects and Side-Effects of Anaesthetic Agents.- The truth about antihypertensive and anaesthetic drugs.- Drug interactions in anaesthesia.- On the toxicity of halothane.- The dangers of anaesthetic agents to personnel working in operating theatres.- Index of subjects.