Awakening.
If the narcosis has been conducted correctly the patient should become conscious promptly after operation. The premonitors of awakening are readily recognized, the corneal reflex becomes more active, the tonicity of the eyelid approaches the normal, a tear may appear in the eye, beads of perspiration are seen on the forehead, the patient may begin to mutter incoherently, the pulse becomes faster, the breathing loses its snoring character, and the patient begins to move his head.
Termination of Narcosis
If the operation is a laparotomy and the patient is under the influence of morphine-anaesthol, the narcosis is terminated by giving a drop occasionally when the surgeon puts his first sutures into the abdominal wall; after the fascial repair, the anesthetic is stopped entirely. The narcosis may be so timed that the patient becomes conscious and responds to questions promptly after the last stitch has been placed.
If the morphine-anaesthol narcosis has been continued with ether by the drop method, as is frequently indicated, and if considerable ether has been used, the patient will be a little tardier in arousing, and the administration of the narcotic should be stopped at an earlier period. To be less abstract, in the case of a laparotomy the anesthetist desists at once from giving ether when the surgeon has applied the peritoneal suture for the closure of the abdominal wound.
Recession of the Tongue After
Narcosis.
Post-operative Asphyxia
Sometimes, especially in individuals who show this tendency during narcosis, a marked obstruction in breathing is met with, attended by increasing cyanosis, a condition due to dropping back or recession of the base of the tongue into the laryngo-pharyngeal space. Changing the position of the head does not improve the breathing, the jaw cannot be pushed forward because the masseter is rigidly contracted and the teeth are clenched tightly. To draw forward the tongue would require a rough procedure, with wedge, gag, and forceps. If a soft rubber catheter or the breathing tube be passed through the nostril into the pharynx the respiratory air streams freely through the tube.