Anaesthesia

Discovered by : Crawford Williamson Long

Discovered in year : 1842

Anaesthesia generally and traditionally means the condition of having sensation (including the feeling of pain) blocked or temporarily taken away. The word was coined by Oliver Wendell Holmes, Sr. in 1846. Anaesthesia is generally induced through Anaesthetics. Anaesthetic is a drug that brings about a reversible loss of consciousness. These drugs are generally administered by an Anaesthesia provider in order to induce or maintain general Anaesthesia to facilitate surgery. Drugs given to induce or maintain general anaesthesia are either given as Gases or vapours (inhalational anaesthetics) or Injections (intravenous anaesthetics). Most commonly these two forms are combined, with an injection given to induce anaesthesia and a gas used to maintain it, although it is possible to deliver anaesthesia solely by inhalation or injection. Desflurane, Isoflurane and Sevoflurane are the most widely used volatile Anaesthetics today.  Propofol, Etomidate, Barbiturates such as methohexital and thiopentone/thiopental, Benzodiazepines such as midazolam and diazepam, Ketamine etc are given through injections. There are several forms of Anaesthesia like General Anaesthesia, Deep sedation/Analgesia, Moderate Sedation/Analgesia or Conscious Sedation and Minimal sedation or Anxiolysis.

History

The first anaesthesia (an herbal  remedy) was administered in prehistory. Opium poppy capsules were collected in 4200 BC, and opium poppies were farmed in Sumeria  and succeeding empires. The use of opium-like preparations in anaesthesia is recorded in the Ebers Papyrus of 1500 BC. By 1100 BC poppies were scored for opium collection in Cyprus by methods similar to those used in the present day, and simple apparatus for smoking of opium were found in a Minoan temple. Sushruta Samhita, a 3rd century B.C Indian text, advocates the use of wine with incense of cannabis for anaesthesia. In the second century, according to the Book of the Later Han and Records of Three Kingdoms, the physician Hua Tuo performed abdominal surgery using an unknown anaesthetic called Mafeisan dissolved in liquor. In the Americas coca  was also an important anaesthetic used in Trephining operations.

Humphry Davy (1778-829), a famous English chemist, discovered through self-experimentation that nitrous oxide relieved headache and dental pain, but his report went unnoticed in the medial community; it did, however, led to the use of 'Laughing Gas' and later ether, for entertainment at parties. The first demonstration of surgical anaesthesia was by Horace Wells (1815-1848), an American dentist who had observed the effects of nitrous oxide at a travelling medicine show. But it was largely considered unsuccessful.

Crawford Williamson Long, an American physician and pharmacist was the first to successfully conduct Anaesthesia during an operation. In March 1842 in Danielsville, Georgia, Dr. Crawford Long during an operation on his friend, James M. Venable, used Ether successfully to remove a cyst from his neck. Long got the idea to do this from his observations at ether frolics. He noted that participants experienced bumps and bruises but afterwards had no recall of what had happened. He did not publicize this information until 1849.

Development in the Discovery of Anaesthesia

On October 16, 1846, dentist William Thomas Green Morton, invited to the Massachusetts General Hospital, performed the first public demonstration of Diethyl Ether (then called sulphuric ether) as an anaesthetic agent, for a patient (Edward Gilbert Abbott) undergoing an excision of a vascular tumor from his neck. In a letter to Morton shortly thereafter, Oliver Wendell Holmes, Sr. proposed naming the state produced Anaesthesia, and the procedure an Anaesthetic.

On 19th December, 1846 in Dumfries Royal Infirmary, Scotland, a Dr. Scott used Ether for a surgical procedure. The first use of Anaesthesia in the Southern Hemisphere took place in Launceston, Tasmania, that same year. Ether has a number of drawbacks, such as its tendency to induce vomiting  and its flammability. In England it was quickly replaced with Chloroform which was discovered in 1831.

The use of Chloroform in Anaesthesia is usually linked to James Young Simpson, who, in a wide-ranging study of organic compounds, found chloroform's efficacy on 4th November 1847. Its use spread quickly and gained royal approval in 1853 when John Snow gave it to Queen Victoria during the birth of Prince Leopold. Unfortunately, Chloroform is not as safe an agent as Ether, especially when administered by an untrained practitioner.

The first effective local Anaesthetic was Cocaine. Isolated in 1859, it was first used by Karl Koller, at the suggestion of Sigmund Freud, in ophthalmic surgery in 1884

A number of Cocaine derivatives and safer replacements were soon produced, including - Procaine in 1905, Eucaine in 1900, Stovaine in 1904, and Lidocaine in 1943.

Role of the Discovery of Anaesthesia in the development of Human Life

• It enhanced and improved surgery procedures.

• People were able to undergo surgeries without the fear of pain.

• A new field named as Anaesthesiology emerged and a new profession named Anaesthesiologists/Anaesthetists developed.

• Agents of Anaesthesia and related equipments became a medical industry in itself.