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MIRACLES OF EPIDURAL ANAESTHESIA
DV MEHER
Ex. Hon. Anaesthetist, JJ Hospital and Bombay Hospial, Mumbai 400 020.
Epidural Anaesthesia (EA), an injection usually given for painless delivery, produces dramatic and miraculous effect in acute heart attack, severe burns, trauma, infection and sepsis, tetanus, asthma, shock, gangrene, virus hepatitis etc. ICU, ventilatory support, antibiotics, monitoring of heart with machine, instant blood gas analysis are surprisingly unnecessary. The fact is that after EA the patients are pain free. They can eat, drink and sleep comfortably.
How does EA achieves this miracle? To understand this it is imperative to know how a disease is caused. This author has proved that it is neither bacteria nor viruses but the lack of adequate blood supply (impaired tissue perfusion) to the affected organs, tissues and cells that causes the disease. (Scientific paper is published in Bombay Hospital Journal, Oct. 1999).
Normally the blood circulates in the body to provide oxygen and nutrients (carbohydrate, proteins and fats) to body cells and remove toxins from the body. This is an autonomous process. The cells in turn, generate energy (ATP) from oxygen and nutrients. This energy is essential for the normal functioning of cells of various organs of the body such as brain, liver, lung, heart, kidneys and immune system. However, when the blood supply to the body, tissues and organs is disrupted due to partial closure of precapillary sphincters of blood vessels after injury caused by physical trauma, chemical injury or biological agent, the energy production in cells declines resulting in dysfunction of cells and the disease. There is also an accumulation of toxins, after disruption of blood supply, which further complicates the disease.
FIG.1: Mechanism of shock.
FIG. 2: General anaesthesia and relaxant.
This basic fact of human physiology is overlooked simply because of our preoccupation with the concept that the germs and viruses are the cause of disease. So, the ‘Hall Mark’ for the treatment of disease is to restore normal circulation so as to generate sufficient energy, which plays an essential role in membrane function and structure, tissue respiration carbohydrate metabolism and various intracellular energy requiring reactions.
FIG. 3: Post arteriolar bed
FIG.4: The cell in shock.
FIG.5 : MSOF syndrome.
EA is the most efficient and effective method of providing abundent supply of blood containing oxygen and nutrients to produce energy needed by affected cells and organs for the function and at the same time removal of accumulated toxins. EA opens all the precapillary sphincters of the affected blood vessels. This provides more than adequate blood supply to affected organs like brain, lung, liver, heart and kidneys which start functioning immediately. The effect is so dramatic that one has to see it to be believed. This dramatic effect after EA, provides a source of immense pleasure and satisfaction to the anaesthetist.
FIG. 6 ----- General anaesthesia and epidural block.
FIG. 7 ----- Increase tissue perfusion.
FIG. 8 ----- ATP for cellular function.
The message is loud and clear. What our Hospitals need, today, is not the machines but the men specialised in EA technic. This will certainly save, both hospitals and patients huge amount of expenses incurred in the treatment, mainly due to use of costly sophisticated machines. To quote Dr. MH Keswani, a burn specialist, that the cost of burn care in this country ranges from Rs. 1,000 to 50,000 a day. Can our poor patients afford this and besides, what is the guarantee of outcome? This author has no doubt that EA is the most rational treatment for burns care which produces dramatic and miraculous effect. The burn wound, which oozes continuously, despite antibiotics and antishock treatment, becomes dry in 24 h. (The paper was presented in International Conference on Burns held in Mumbai in 1980).
Epidural Anaesthesia has opened a new horizon for medical profession. It has a vast therapeutic potential. I am confident that EA will produce dramatic effect even in human rabies, food poisoning, liquor tragedies and many more unsolved mysterious diseases such as cancer. AIDS, leprosy etc. It will prove an exceptionaly valuable and unique tool for further research in medicine
Epidural Anaesthesia generates ATP and restores cellular and organ function.
ACKNOWLEDGEMENT
My special thanks to Mrs. Lakshmi Subramaniam who corrected the manuscript.
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