The Riddle of Shock: Spinal Anaesthesia

Spinal set, originally from St Christopher’s Hospice, London

Spinal set, originally from St Christopher’s Hospice, London

Spinal set

At first, spinal anaesthesia was thought to protect from shock. Geoffrey Marshall realised that its use was disastrous and advised the use of nitrous oxide and oxygen.

The development of syringes

“I have one large needle for my whole Pavilion, and give an average of fifteen injections a day… the doctor frequently asks to borrow it for another hospital”

Diary of Mademoiselle Miss, American Red Cross Nurse, 15th November 1918

Syringes seem to have been first noted as an invention by Hero of Alexandria (c. 10-70 CE). Two metal syringes were discovered on the wreck of the Mary Rose which sank in 1545, and in 1656 Sir Christopher Wren and Robert Boyle carried out the first intravenous injection of a drug into an animal using a bladder attached to a sharpened quill.

Francis Rynd, a Dublin surgeon, invented the hypodermic trocar, in 1845. This was a sharp-pointed surgical instrument that could be used to insert a cannula as a drainage outlet.

Syringes were developed from these. From 1896 they were made entirely of glass, with disposable, plastic sterile needles and syringes not available until 1959. Syringes and needles during the First World War would have been reused, and sterilised and sharpened between patients.

Kidney dish and Barker needle

Barker’s spinal needle

A slightly flexible needle, into which a stilette fits accurately, its point cut obliquely at the same angle as that of the needle-point.  A cannula can be passed down the needle to help ensure the fluid is injected below where the spinal cord ends.

Kidney dish

The shape of the dish allows it to be held against the patient’s body to catch debris or fluids. Kidney dishes were used to hold instruments too.

 

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