THE EFFECT OF INHALATION ANESTHESIA ON INTRACRANIAL PRESSURE

The extensive research in recent years on the cerebrospinal fluid and its circulating system¹ has demontrated that ether, among certain other drugs, accelerates the formation of cerebrospinal fluid. Dixon and Halliburton² have shown that both ether and chloroform markedly increase the cerebrospinal fluid pressure. Whether this increase of pressure is due to an excessive formation of the fluid or to other factors remains to be determined. In clinical work I have repeatedly demonstrated an elevation of cerebrospinal fluid pressure attending inhalation anesthesia when induced by ether, chloroform or nitrous oxide. The elevation is probably most pronounced in the latter, and I believe that this is due to the elevation of intrathoracic pressure, which in turn produces cerebral venous stasis and diminished absorption of cerebrospinal fluid.

Many surgeons, in operating on patients with increased intracranial pressure, have observed the development of profound medullary disturbance apparently inaugurated by the anesthetic,