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PEREDA, RACHEL B. November 9, 2011

ANES 220 DDC Assignment

Anesthesia - the condition of having sensation blocked or temporarily taken away. It is

a pharmacologically induced and reversible state of analgesia, loss of responsiveness, loss of skeletal

muscle reflexes or decreased stress response, or all simultaneously.

Anesthetic agent - a drug that causes temporary loss of bodily sensations

The History of Anesthesia and Its Prominent Pioneers

Introduction

Anesthetic practices date from ancient times. Ancient civilizations had used opium poppy, cocoa leaves,

mandrake root, and even phlebotomy to allow surgeons to operate. Egyptians used the combinations of 

opium poppy and hyoscyamus, similar to today’s morphine and scopolamine. Regional anesthesia then

was consisted of compression of nerve trunks or application of cold.

Inhalational Anesthesia

The first general anesthetics were inhalational agents; ether, nitrous oxide, and chloroform. Ether was

originally prepared by Valerius Cordus in 1540 but was not used as an anesthetic agent in humans until

1842, when Crawford W. Long William E. Clark used it independently on patients. Four years later,

William T.G Morton conducted the first publicized demonstration of general anesthesia using ether.

Nitrous oxide was produced by Joseph Priestly in 1722, but its analgesic properties were first noted byHumphry Davy in 1800 while Gardner Colton and Horace Wells were first to implement on humans.

Chloroform was independently prepared by von Leibig, Gutherie and Soubeiran in 1831 but James

Simpson was the first to introduce it to clinical practice. Until the 1950s, all the available inhaled

anesthetic possessed at least two defects; explosive in oxygen or toxic.

Local & Regional Anesthesia

The origin of modern local anesthesia is credited to Carl Koller, an ophthalmologist, who demonstrated

the use of topical cocaine for surgical anesthesia of the eye in 1884. The surgeon William Halstead

demonstrated in 1884 the use of cocaine for intradermal infiltration and nerve blocks. August Bier, the

first to describe intravenous regional anesthesia, is credited with administering the first spinal

anesthetic in1898. Procaine was synthesized in 1904 by Alfred Einhorn while Heinrich Braun was first to

add epinephrine to prolong the action of the local anesthetic. Caudal epidural anesthesia was

introduced by Ferdinand Cathelin and Jean Sicard. Lumbar epidural anesthesia was described first by

Fidel Pages and again by Achille Dogliotti.

Intravenous Anesthesia

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Induction agents

Intravenous anesthesia followed the invention of the hypodermic syringe and needle by Alexander

Wood. Barbiturates were synthesized by Fischer and von Mering. The first barbiturate was

diethylbarbituric acid. Thiopental was first clinically used by John Lundy and Ralph Waters. Ketamine

was the first intravenous agent associated with minimal cardiac and respiratory depression.

Muscle Relaxants

The use of curare by Harold Griffith and Enid Johnson was a milestone in anesthesia. For the first time,

surgery could be performed on patients without having to administer relatively large doses of anesthetic

to produce muscle relaxation.

Opioids

Morphine was isolated from opium by Serturner and subsequently tried as an intravenous anesthetic.

The morbidity and mortality associated with high doses of Opioids in early reports caused many to avoid

Opioids.

Evolution of the Specialty

John Snow, generally considered the father of anesthesia, became the first physician to take a full-time

interest in this new anesthetic, for which he invented an inhaler. He was the first to scientifically

investigate ether and the physiology of general anesthesia.