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George Edward Hale Enderby

BMJ 2004; 328 doi: (Published 20 May 2004) Cite this as: BMJ 2004;328:1263

A pioneer of hypotensive anaesthesia

Hale Enderby is best known for his pioneering work in hypotensive anaesthesia. This is the technique of lowering blood pressure during surgery, making operations safer and more rapid, and enabling more complicated surgery while controlling blood loss from the patient.

In 1948-9 the pharmacologists Paton and Zaimis first described a range of new drugs, the methonium compounds, some of which could lower blood pressure. Hale Enderby saw that this fall in blood pressure could be used to lessen bleeding during surgery—the snag was measuring the low blood pressures. Early methods of measurement relied on using a mercury column, but the Korotkov sounds become inaudible below 60 mm Hg systolic. The pulse also becomes impalpable at that pressure. However, this was the level of blood pressure needed to reduce bleeding significantly. Hale Enderby introduced into anaesthesia the oscillometer, an older and largely forgotten method of blood pressure measurement but one that proved capable of measuring accurately these low pressures. He was also responsible for introducing the …

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