HISTORY OF ANAESTHESIA

ANESTHESIA BEFORE
ETHER
 The Edwin Smith Surgical Papyrus, the
oldest known written surgical document,
describes 48 cases performed by an
Egyptian surgeon from 3000 to 2500 BC
 no direct mention of measures to lessen
patient pain or suffering.
Early Analgesics
 Alcohol.
 Inhaled Anesthetics
 diethyl ether was certainly known in the
sixteenth century, both to Valerius Cordus
and Paracelsus, who prepared it by distilling
sulfuric acid (oil of vitriol) with fortified wine
to produce an oleum vitrioli dulce (sweet oil of
vitriol).
 For three centuries thereafter, this simple
compound remained a therapeutic agent
with only occasional use.
 Nitrous oxide was first prepared in 1773 by
Joseph Priestley.
 Horace Wells’
 in January 1845, Wells attempted a public
demonstration in Boston at the Harvard
Medical School. He had planned to
anesthetize a patient for an amputation,
but, when the patient refused surgery, a
dental anesthetic for a medical student
was substituted. Failure.
 he committed suicide in 1848.
 William Thomas Green Morton
 experiments with inhaled ether.
 Morton gained an invitation to give a
public demonstration in the Bullfinch
amphitheater of the Massachusetts
General Hospital, the same site as Wells'
failed demonstration,October 16, 1846,
REGIONAL ANESTHESIA
 Cocaine, an extract of the coca leaf, was
the first effective local anesthetic.
 Albert Niemann refined the active
alkaloid and named it cocaine.
 Carl Koller, a Viennese surgical intern, first
recognized the utility of cocaine in clinical
practice.
SPINAL ANESTHESIA
 Professor Bier permitted his assistant, Dr.
Hildebrandt, to perform a lumbar
puncture.
Control of the Airway
 Joseph Clover was the first Englishman to
urge the now universal practice of thrusting
the patient's jaw forward to overcome
obstruction of the upper airway by the
tongue.
 The first use of elective oral intubation for
an anesthetic was undertaken by Scottish
surgeon William Macewan. 1878
 The most distinguished innovator in tracheal
intubation was the self-trained British
anesthetist Ivan (later, Sir Ivan) Magill.
PATIENT MONITORING
 Joseph Clover was one of the first
clinicians to routinely perform basic
hemodynamic monitoring.
INTRAVENOUS
MEDICATIONS
 Alexander Wood, is generally credited
with perfecting the hypodermic glass
syringe. 1855.
 In 1872, Pierre Oré of Lyons performed
what is perhaps the first successful
intravenous surgical anesthetic by
injecting chloral hydrate.
 Thiopental was first administered to a
patient at the University of Wisconsin in
March 1934.
 Ketamine, was released for use in 1970.
 Opium is derived from the seeds of the
poppy (Papaver somniferum), and is an
amalgam of over25 pharmacologic
alkaloids.
 The first alkaloid isolated, morphine, was
extracted by Prussian chemist Freidrich
A.W. Sertürner in 1803.
 Curare, the first known neuromuscular
blocking agent, was originally used in
hunting and tribal warfare by native
peoples of South America.
 Curare was used initially in surgery by
Arthur Lawen in 1912.
WHAT IS ANESTHESIA?
 General anesthesia can broadly be defined
as a drug-induced reversible depression of
the central nervous system resulting in
the loss of response to and perception of
all external stimuli.
 components of the anesthetic state
include unconsciousness, amnesia,
analgesia, immobility, and attenuation of
autonomic responses to noxious
stimulation.