Diethyl ether anesthetic is the first volatile anesthetic agent used widely for over one-and-a-half centuries.
Volatile anesthetic agents like Ether, ethylene, chloroform, trichloroethylene and methoxyflurane are not in use in developed countries. However, ether, trichloroethylene are still in use in some developing countries.
Physical properties of Diethyl ether anesthetic : It has a boiling point (bp) of 35°C, vapour pressure (VP) 442, blood/gas coefficient 15.2, oil/ gas coefficient 50.2, MAC 2.5%, 50% metabolism, flammable and ignites at 154°C, decomposed by air, light and heat. It is metabolized to ethanol —> acetaldehyde —> acetic acid -> Co2+H20.
It is highly irritant, unpleasant and flammable in anesthetic range. There is a very high (50%) incidence of postoperative nausea and vomiting (PONV), with the use of diathermy and its other unpleasant effects it is out of use in most countries.
However, diethyl ether anesthetic is cheap, available and safe agent. Diethyl ether anesthetic stimulates the sympathetic system, so sustains BP and produces tachycardia. Induction is slow because of coughing due to irritation of the respiratory tract. So, a potent and pleasant agent was used to assist induction prior to ether, however it cannot be used for longer period due to its toxic cardiac effects. The stages of anaesthesia had been described in detail by Arthur Guedel, which is a classic. He described four stages of anaesthesia and four planes in the third stage, wherein the 2nd plane was considered suitable fbr surgical operations.
Open drop diethyl ether anesthetic is simple, it needs a mask (Shimmelbusch/Yankouer) and ether in a dropper, an ethyl chloride spray, 4-8 thickness gauze over the mask, oxygen cylinder, suction machine and basic resuscitation.