The History and Evolution of Anesthesia

αναισθησία, ασπρόμαυρη φωτογραφία, γιατροί στο χειρουργείο

The history of anesthesia is a remarkable tale of human ingenuity and medical progress. Before the discovery of anesthesia in the mid-19th century, surgeries were excruciating ordeals often accompanied by severe pain and trauma. The breakthrough came with the use of ether and chloroform, which allowed surgeons to perform procedures painlessly, revolutionizing medicine.

This monumental advancement transformed the surgical landscape and opened the doors to many medical possibilities, making complex procedures and interventions accessible and safe for patients worldwide. The history of anesthesia remains a testament to the relentless pursuit of improving healthcare and alleviating human suffering.

In ancient Greek texts, the etymology of the word anesthesia is described as follows (anaisthēsíā, "without sensation") from the negative ἀν- (an-, "without") and αἴσθησις (aisthēsis).

Anesthesia in the Archaic Period

- Anesthesia , as a practice, appeared as early as archaic times, when according to records, opium, Papaver somniferum, many herbs, and alcohol were used to relieve pain during medical procedures. Historical records show attempts to administer general anesthesia to the ancient Sumerians, Babylonians, Assyrians, Egyptians, Indians, and Chinese.

Over the centuries, practitioners have made many attempts to relieve pain. In archaic times and before the development of modern medicine, there were testimonies of knocking the patient's head or applying pressure to the carotid arteries to induce unconsciousness.

Anesthesia in the Medieval Times

Opium was also widespread, especially in China, and used intravenously in 1660. Other pain relief techniques included intense pressure on the nerves in the extremities or applying cold water, ice, or snow. Finally, in the 18th and 19th centuries, hypnotism developed a lot as an analgesic and therapeutic method.

Before developing anesthetic substances and discovering general anesthesia, surgery was the last resort to save the patient's life. According to the rescued documents, the conditions under which an operation took place were inhumane, torture, and barbaric, as the patient had to be immobilized by any means.

Under these conditions, only procedures related to the body's surface, dealing with kidney stones (gallstones) and amputations, could be performed. It was typical that a good surgeon at the time was a fast surgeon, as he could limit his patient's agony and suffering.

As a result of the way the surgeons performed the operations, the patients had a poor prognosis, with most of them dying during surgery or in the immediate postoperative period.

Anesthesia in the Modern Era

In the 16th century, the Swiss physicist Paracelsus experimented with ether as an anesthetic gas and introduced chemical anesthesia as a concept for the first time. With ether as a starting point, experiments continue to search for and develop effective anesthetic substances.

In the two following centuries, among others, nitrous oxide, a gas still used today, is produced. Although Paracelsus experimented and described the administration of anesthesia in animals as early as 1540, the first general anesthesia in humans was performed in 1842 by Drs Long and Clark.

The First Use of General Anesthesia During a Surgery

On October 16, 1846, the American anesthesiologist William Morton administered ether anesthesia at the Massachusetts General Hospital in Boston to perform the removal of a submandibular lymph node by surgeon John Warren. The patient who was to go down in history as the first official patient operated on under general anesthesia was Gilbert Abbott.

Morton introduced anesthesia to the general public for the first time, which made him a pioneer and thus ushered in a new era for anesthesiology, as it was the first time anesthesia's administration and effectiveness were presented to the broader scientific world.

The successful administration of anesthesia at the Massachusetts hospital became known outside the American medical community in Boston and in London, where the events were recorded by English physicians who were present during the operation.

It's worth mentioning that the operating room in which they performed the first surgery with general anesthesia, the so-called Ether Dome, is preserved intact to this day at the Massachusetts General Hospital.

The Evolution of Anesthetics

A milestone in the development of anesthetic substances was the use of cocaine in 1877, which was used as a local anesthetic for peripheral nerve blocks and for spinal and epidural anesthesia.

- first recorded use in spinal anesthesia was recorded in 1885 in New York by Dr. Corning, while in 1901, he successfully completed epidural anesthesia with the same substance. Due to the highly addictive nature of cocaine, scientists developed its derivatives, which are just as effective and safer to administer.

In addition to anesthetic agents, a vital step in developing anesthesiology was the discovery of ventilation tubes placed in the trachea during general anesthesia. Technical ventilation and its variations were developed in the 19th century.

After the 1930s, medical professionals also introduced intravenous anesthetic drugs, while in the second half of the 20th century, muscle relaxants were administered for the first time. The first muscle relaxant used was curare, which until then was used in hunting, as it was commonly known as the South American Indian poison. At the same time, research subsequently provided the anesthesiology community with various muscle relaxants.

Takeaway

The introduction of anesthesia fundamentally changed the field of surgical operations. Surgeons can operate without time pressure, at least in scheduled operations, so they can be accurate and radically improve service quality.

Also, surgeons can now perform operations on all body parts without restrictions. The most important factor, of course, is the patient, who is now operated on without suffering and agony and without the experience of the surgery being forever etched in his/ her mind as traumatic.

Today the anesthetic substances,in combination with the continuous and detailed control of the patient's vital signs during an invasive examination or surgery and providing the experience and proper preparation of the patient and the doctor according to the individual needs, are safe drugs, the benefits and effectiveness of which outweigh the possible side effects.

In addition to surgical operations, anesthetic drugs are also administered in emergency pre-hospital medicine, in intensive care units, in treating acute and chronic pain, in painless childbirth, and in other medical conditions.