Rectal Anesthesia and Sedative Enemas before surgery

I am sure I had ether once I was in the or.

While anesthesia by enema is likely very rarely used these days, it seems to have been an option in the 60's and before.

Whoa rectal anesthesia. Never heard of that before. Interesting.

Rectal anesthesia and sedation is older than dirt, which is probably the main reason people haven't heard of it lately.

Wow thats interesting i never heard of such a thing

I had my tonsils out at 4 or 5 which would have been about 1956 or 57. I got gas and nothing rectally and was dreading an enema since I knew everyone got them. I got in and out in a couple days and didn't get an enema which I was thankful for and didn't complain about. I have no memory of going home but if I had to guess I probably got one once I got home.

Had my foot put back together in the early '90s as a teenager. After the accident there was some ribbing about getting an enema, but I went through the surgery and overnight with nothing going up my butt that I know of. Temps were oral, and the anesthesia was IV. Like Moppy I was overjoyed.

Didn't know what to expect from the anesthesia going in, but decided i didn't like it, an opinion which subsequent experiences have solidified. I don't know if getting it up the ass would have made me like it any more, but I doubt it, especially given my thinking at the time.

There were 3 drugs used for rectal anesthesia. Up until the 1970's a version of Sodium Penothal® suitable and packaged for rectal use available from Abbott Laboratories IIRC. The dose in the product was suitable only for children up to about the age of 7 or 8. The main issue with this route of administration is there is considerable variation in the rate of absorption, and to guard against possible respiratory arrest, an anesthesiologist had to be present from the time the drug was administer until it took effect which could be anywhere for a couple of minutes to 20 minutes or so.

Tribromoethanol dissolved in tert amyl alcohol was also used, probably well into the 1960's, marketed as Avertin®. Dose was on the order of 100mg/kilogram in water, not to exceed 3% Avertin. The main problem with Avertin is that it was PIA to use. It wasn't especially stable, so certain tests had to be run on the product immediately prior to use, and care had to be used in preparing the product for use not to exceed the temperature limits. It wasn't a particularly good anesthetic, but a pretty good hypnotic, so once the patient was unconscious, more effective anesthesia drugs could be used. It generally produced unconsciousness in a 3-5 minutes. It is still used today in some procedures on rodents and other small animals, however it is injected

Lastly ethyl ether in oil, generally cottonseed oil. I think this probably fell out of use in the 1930's, but beyond that I don't know much about it.

Some of the Benzodiazepines usually valium (diazepam) are available today for rectal administration, generally for use in severe seizures, where IV access is often impractical because the patient actually is still seizing.

Very informative post Matthew. Great job.

A topic that I knew nothing about

Years ago I had an older and very professional play doctor whom I met regularly during a period of about five years.

We learned to know each other pretty well and he had a huge collection of instruments, syringes and other stuff.

Everytime I met him I immediately had to undress and he started the game by taking my rectal temperature. It was followed by one or two enemas. I was then inspected via insertion of a speculum or a proctoscope to confirm that I was clean inside before the game went on.

Once he liked to give me an enema which he had got himself as a child prior to an operation and which put him to sleep. He told me it was an ether enema and described the procedure and its effects.

I was hesitant but finally I agreed to it. He started mixing and preparing the enema solution from bottles he had in his cabinet. I was a bit scared but also very curious as I naked was laying on the exam bed waiting for him. The smell of ether quickly filled the room as it was mixed with something else and filled into a big enema syringe. That smell immediately reminded me of my childhood an some unpleasent doctor visits...

My heart was beating very hard as he approached me where I was laying on my back waiting for the enema.

I had to lift and separate my legs. He quickly greased my anus so he could insert a rubber tube a bit inside me. The syringe was already fixed to the tube and soon he started injecting the liquide.

I don´t know how much I got injected. I think it was very little. But immediately I could feel the taste of ether on my tongue and how the taste also filled my mouth as I quickly became very dizzy.

I really didn´t risk to fall asleep so I asked him to finish the administration of the liquide which he did. Immediately I run to the toilet to try to expel it and shortly after I was giving a clear water enema to help clean it out.

It certainly was an interesting experience to see how efficient and quickly it really worked and had I been a child I would certainly have prefered that option of anaesthesia ahead of anything else.