What is Anesthesia?
Interventions that eliminate the pain of surgery that provides partial or total loss of sensation. Loss of ability to feel pain by medical intervention. There was surgery before anesthesia. Most of our anesthetics started out by trial and error, and most were not trialed with the intent of relieving the suffering of human kind. Most were trialed as recreational chemicals (opium, alcohol, coca leaves).
Phlebotomy was performed by bleeding out the patient until the became unconscious. Nerve compression and cold therapy were also utilized. Surgeons wanted the patient to hold as still as possible to maximize exposure (keep screams to a minimum to minimize distractions to the surgeon).
Trial & Error
Alcohol: increased blood loss.
Coca Leaves: local anesthetics came out of this.
Phlebotomy: exsanguinate the patient until they lost consciousness.
Nerve Decompression: this was considered fairly effective.
Cold: Was only available in certain areas on certain times of the year.
Mandigorria: a plant that produces scopolamine type compound. Great sedated qualities.
History of Pain
Pain was considered a distraction to the surgeons and thought of as a punishments for sin or misdeeds. During that time it was not considered ethically reasonable to diminish these peoples’ pain. Before anesthesia the best surgeons were fast (patients would be held down by strong assistants).
Significant Figures in Anesthesia
Oliver Wendell Holmes (1846)
He was an Anatomy & Physiology professor who defined anesthesia. “Anesthesia is a sleep like state that allows painless surgery.”
Dr. Robert Listen (1842)
He was one of London’s best surgeon because he could amputate a leg in a little over 45 seconds. But in this particular surgery he amputated the leg, the patient got an infection and later died. While he was amputating the leg in this rather rapid fashion he cut off the fingers of one of his assistants who was holding the leg of the patient. This patient also became infected and later died. And while the patient who got his fingers cut off was screaming and the doctor moved over to see what had happened he got blood all over the coat of one of the residents that was observing the surgery and he thought that his vital organs had been puncture, and he had a heart attack and also died. (3 deaths from one surgery!)
Valerius Cordus (1540)
He synthesized and wrote the formula down a purified form of ether. The product was made from ethyl alcohol and sulfuric acid and was formulated as a recreational drug that was drank.
Joseph priestly (1773)
A clergymen in England and was also a budding chemist who purified Nitrous Oxide and discovered photosynthesis. Nitrous oxide is made by burning ammonium in the presence of iron molecules. During his experiments he actually purified oxygen but didn’t know it.
Humphrey Davy (1800)
He investigated the use of nitrous oxide on his patients and himself and wrote a 500pg book on the effects of nitrous oxide.
Henry Hill Hickman (1824)
Also looking for a painless way to do some dental procedures experimented with Carbon Dioxide. The problem was patients would become hypoxic.
Samuel Colt (1835)
Learned how to make nitrous oxide in a tanning factory, traveled the country selling hits of nitrous oxide to make you feel good for 25 cents a piece. He used this money to pay for his patent on an invention which was a Gun, one with six chambers that would advance every time it was cocked (Colt revolver).
Jean Baptiste Andre Dumas (1834)
Given credit for purifying Chloroform. Chloroform is a liquid and very potent but it’s drawback is that it can explode and is very toxic. He used this purified chloroform to set a bone and pull some teeth.
William Morton (1846)
He was looking for a way to prevent pain from putting in dentures. Took lessons from Horace Wells on how to prepare and administer the nitrous oxide. A surgeon named Bigolo saw Morton using this ether to fit dentures and decided this was the drug that was going to be used during surgery. Bigolo arranged for Morton to give a presentation at the Massachusetts hospital in 1846. But Morton wanted to make money and disguised the ether by inventing a vaporizer. The presentation was successful and by the end of the year there were ether anesthetics being given all over London. The Vaporizer was a HUGE invention.
Edmund Andrews (1868)
Figured out that Oxygen in NO2 was not available and needed to be added and did at 20% with NO2. Called it “Anesthesia without turning blue”.
Sir James Simpson (1847)
Went back to Chloroform and was looking for an anesthetic that did not have the problems that ether had like being slow and making people puke. Chloroform use was not very successful. Ether is cardiac stable with very little respiratory depression, and it has a wide therapeutic index. Chloroform on the other hand had significant respiratory depression, and if you happened to get sympathetic nervous system stimulation the patient went into V-Fib. He promoted the use of chloroform, but also promoted the idea that pain came from actual or potential tissue damage. He overturned the idea that pain was a punishment from God.
Dr. John Snow (1853)
He was the 1st Anesthesiologist. He was also the first person who dedicated their entire practice of Medicine to Anesthesia. Also known for delivering Chloroform to Queen Victoria for the birth of Prince Leopold.
Brought cleanliness/public health changes which drastically decreased the death rates in all hospitals.
Used Carbolic Acid to clean up operating rooms.
Developed Germ Theory and no one believed him.
Sister Mary Bernard (1877 )
1st Nurse Anesthetist (However nurses were administering anesthesia during the civil war). Trained with postgraduate nursing education in anesthesia. Most of the training back then was hands on.
She was considered the “Mother of anesthesia” and helped develop anesthesia machines.
Canadian nurse that came to Ohio and established the AANA. She also helped change the face of anesthesia by decreasing the death rate.
Dr. Arthur Guedel (1919)
He described in detail the stages that the patient would go through. These stages were very predictable. He created a chart about the stages of an anesthetic which quickly became an accepted doctrine.
Learn more about the history of anesthesia in CRNA school. Top Nurse Anesthetist Programs will provide you with a rich and in-depth background study of this topic, as well as prepare you with the skills to become a Nurse Anesthetist prepped with knowledge of current practices used in the field today.
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