History of Anesthesia Etymology and Development

Etymology of Anesthesia

• "Anesthesia" was defined as "defect of sensation" in 1721
• Oliver Wendell Holmes used the term "anesthesia" to describe the sleeplike state that makes painless surgery possible in 1846

History of Anesthesia

• Ancient civilizations used natural substances like opium poppy, coca leaves, and mandrake root for pain relief during surgery
• Egyptians combined opium poppy (containing morphine) and hyoscyamus (containing scopolamine) for pain management
• Ether was prepared in 1540 by Valerius Cordus
• Ether was used on patients in 1842, but the discovery was not publicized
• The first successful surgical anesthesia using ether was performed in Boston on October 16, 1846
• Chloroform was independently prepared in 1831
• Chloroform first used in 1847
• Chloroform was used clinically by Professor James Simpson for pain relief during labor
• Nitrous Oxide (N2O) was produced in 1772
• Humphrey Davy observed the analgesic properties of Nitrous Oxide in 1800
• Horace Wells first used nitrous oxide for human anesthesia in 1844
• Intravenous anesthesia became possible with the invention of the hypodermic syringe in 1855
• Pierre Cyprien Ore pioneered intravenous anesthesia with chloral hydrate in 1872
• Barbiturates were synthesized in 1903 for anesthesia induction
• Ketamine was synthesized in 1965 and first used clinically in 1970
• Propofol was released in 1986 and is now the most popular intravenous anesthetic worldwide

Development of Anesthesia as a Specialty

• Anesthesiology emerged as an independent medical specialty in the early 20th century
• Ether anesthesia quickly became popular in England
• John Snow is considered the father of the anesthesia specialty
• The first organization of physician specialists in anesthesia, "The Society of Anesthetists," was founded in England in 1893
• The first organization of physician anesthetists in the United States, the Long Island Society of Anesthetists, was formed in 1905

Anesthesia in Saudi Arabia

• Dr. Mohamed Ishaq Al Khawashki recognized the need for anesthesia technicians due to a shortage of anesthesiologists and the growth of surgical services in Saudi Arabia
• Professor Mohammed Abdullah Seraj is considered the "Father of Anesthesia in the Kingdom of Saudi Arabia"
• The anesthesia department at King Abdul-Aziz University Hospital was established with two operating theaters and 70 beds
• Professor Seraj developed the curriculum for the bachelor's degree in Anesthesia

Roles and Responsibilities in Anesthesia

• Anesthesiologists provide pre-operative, intra-operative, and post-operative care for surgical patients
• Anesthesia technologists work under the direction of anesthesiologists and provide essential support during anesthesia procedures
• Responsibilities of anesthesiologists include:
  • Evaluating patients before surgery
  • Consulting with the surgical team
  • Providing pain control
  • Supporting life functions during surgery
  • Supervising post-operative care

Clinical Practice of Anesthesia

• Anesthesiologists monitor vital functions including heart rate, breathing, blood pressure, and body temperature to ensure patient safety during surgery
• Anesthesiologists diagnose and treat any medical problems that arise during surgery or recovery
• Anesthesiologists manage pain levels and anesthesia depths to ensure a comfortable and safe procedure
• After surgery, patients are transferred to the recovery room and monitored for recovery from anesthesia
• Anesthesiologists also provide sedation for procedures outside of the operating room like MRI and catheterization
• Anesthesiologists participate in cardiopulmonary resuscitation
• They manage pain for childbirth and provide pain management for chronic pain problems.

References:

• Clinical Anesthesiology, 6th edition, 2018, G. Morgan, Maged Mikhail, and Michael Murray, Chapter 1, pages 1-6

The History of Anesthesia

• The term "anesthesia" was first defined in 1721 as "defect of sensation".
• The modern meaning of anesthesia (sleeplike state for painless surgery) was used by Oliver Wendell Holmes in 1846.
• Ancient civilizations including Egyptians used substances like opium poppy, coca leaves, mandrake root, and alcohol for pain relief during surgery.
• The Egyptians used a combination of opium poppy (containing morphine) and hyoscyamus (containing scopolamine) to achieve pain relief.
• Crawford W. Long and William Clark successfully used ether on patients in 1842, but did not publicize their findings.
• The first documented surgical anesthesia was successfully performed in Boston on October 16, 1846 using ether.
• Chloroform was independently prepared in 1831 by Von Leibig, Guthrie, and Souberian.
• Chloroform was first used in 1847 by Holmes Coots, and later popularized for pain relief during childbirth by Professor James Simpson.
• Produced by Joseph Priestly in 1772, Nitrous Oxide (N2O) was first noted for its analgesic properties by Humphrey Davy in 1800. Horace Wells introduced its use for anesthesia in humans in 1844.
• The invention of the hypodermic syringe and needle by Alexander Wood in 1855 allowed for intravenous anesthesia.
• Pierre Cyprien Ore pioneered the use of intravenous anesthesia (IVA) by introducing chloral hydrate in 1872.
• Barbiturates were synthesized in 1903 and were initially used for inducing anesthesia.
• Ketamine was synthesized in 1965 by Stevens and first used clinically in 1970.
• Propofol, which is currently the most widely used intravenous anesthetic, was released in 1986.
• The development of anesthesiology into a distinct medical specialty didn't occur until the early 20th century.
• Ether anesthesia was quickly adopted in England in 1893, and "The Society of Anesthetists" was formed, the first organization of physician anesthesiologists.
• The first organization of physician anesthesiologists in the United States was the Long Island Society of Anesthetists, established in 1905.

Anesthesia in Saudi Arabia

• Due to a shortage of anesthesiologists and the increasing demand for surgical services in Saudi Arabia, Dr. Mohamed Ishaq Al Khawashki proposed the creation of technical institutes to train anesthesia technicians to work under the supervision of consultant physicians. This was known as the "technician's era."
• Professor Mohammed Abdullah Seraj is considered the "father of anesthesia" in Saudi Arabia. He established the first anesthesiology department at King Abdul-Aziz University Hospital, King Saud University, which had only two operating theaters and 70 beds.

Roles and Responsibilities

• Anesthesiologists are physicians specifically trained in anesthesia, completing a six-year medical school program followed by four years of anesthesiology residency training.
• Anesthesia technologists work under the supervision of anesthesiologists as a vital part of the anesthesia care team.
• The role of an anesthesiologist encompasses a wide range of perioperative services, including:
  • Preoperative patient evaluation,
  • Consulting with surgical teams,
  • Providing pain control throughout the surgery,
  • Maintaining vital functions during surgery,
  • Supervising postoperative care.

Essential Functions

• Anesthesiologists are responsible for continually monitoring and controlling a patient's vital functions, such as:
  • Heart rate and rhythm,
  • Breathing,
  • Blood pressure,
  • Body temperature,
  • Fluid balance.
• Anesthesiologists can diagnose and treat medical problems that arise during surgery or recovery.
• Anesthesiologists are also responsible for pain management, with a focus on both acute and chronic pain conditions.
• After surgery, patients are admitted to the recovery room for observation by skilled nursing personnel before being transferred to a regular room or home.
• Anesthesiologists can perform various procedures, including sedation for procedures outside the operating room (e.g., MRI, cardiac catheterizations) and cardiopulmonary resuscitation.