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The psychologic effect of the preoperative visit by an anesthetist has been compared with the effect of pentabarbital for preanesthetic medication. Patients receiving pentobarbital 1 hour before an operation became drowsy but it could not be shown that they became calm. Patients who had received a visit by an anesthetist before operation (informing them about the events which were to occur on the day of the operation and about the anesthetic to be administered) were not drowsy but were more likely to be calm on the day of the operation. The importance of the preoperative visit probably explains, in part, the difficulties previous investigators have had in showing sedative effects from barbiturates and narcotics before operation. The tremendous emotional significance to a patient of illness or an operation may explain why physicians are able to exert such influence upon their patients.

Twelve male volunteers inspired concentrations of carbon dioxide in oxygen ranging from 7% to 14% for periods of 10– 20 minutes. Respiratory minute volume, arterial pressure, heart rate, and plasma concentrations of epinephrine, norepinephrine and 17-OH corticosteroids were increased in every subject during hypercarbia. Abnormal cardiac rhythm was infrequently observed. Following substitution of oxygen for the carbon dioxide-oxygen mixture, the altered measurements returned to normal over a period of roughly 10 minutes. Neither marked hypotension nor cardiac arrhythmia was observed after correction of hypercarbia. Submitted on January 8, 1960

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