Anesthesia

• general anesthesia — with reversible loss of consciousness
• local anesthesia — with reversible loss of sensation in a (small) part of the body by localized administration of anesthetic drugs at the affected site.
• regional anesthesia — with reversible loss of sensation and possibly movement in a region of the body by selective blockade of sections of the spinal cord or nerves supplying the region.

Table of contents

1 History 1.1 Non pharmacological methods 1.2 Herbal derivatives 1.3 Early gases and vapours 1.4 Local anaesthetics 1.5 Early opioids 1.6 The twentieth century 2 Choice of anesthetic technique 3 Related topics 4 External links

History

Herbal derivatives

Another dentist, William E. Clarke, performed an extraction in January, 1842 using a different chemical, ether (discovered in 1540). In March, 1842 in Danielsville, Georgia, Dr. Crawford Williamson Long was the first to use anaesthesia during an operation; giving it to a boy before excising a cyst from his neck. In October 1846 yet another dentist, William Thomas Green Morton, removed a tumour from an patient under ether. Despite Morton's claims of a new gas called 'Letheon' the use of ether spread to Europe in late 1846. Here respected surgeons including Liston, Dieffenbach, Pirogoff, and Syme undertook numerous operations with ether.

Ether had a number of drawbacks and was quickly replaced with chloroform. Discovered in 1831 its use in anaesthesia is usually linked to James Young Simpson. Who, in a wide-ranging study of organic compounds, found chloroform's efficacy in 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.

Local anaesthetics

The twentieth century

• MAC (minimum alveolar concentration) % atm - methoxyflurane 0.16
• Thiopental (first used 1934
• intravenous, Benzodiazepine)
• Curare (1942)
• Fentanyl (d 1960 Paul Jannsen) fentanyl citrate
• Halothane (d 1951 Charles W. Suckling, 1956 James Raventos) MAC, non-explosive/inflammable. Halothane hepatitis, malignant hyperthermia, hepatotoxic
• Succinylcholine
• Enflurane (d 1963 u 1972), Isoflurane (d 1965 u 1971), Desflurane, Sevoflurane
• New synthetic opioids - meperidine, alfentanil, sufentanil (1981),
• Neurosteroids

However, when either technique is possible, regional anesthesia is about 30% safer than general anesthesia. Neuraxial blockade reduces the risk of deep vein thrombosis, pulmonary embolism, transfusion, pneumonia, respiratory depression, myocardial infarction and renal failure[1].

Related topics

• Anesthesia awareness
• Latex allergy
• Allergic reactions during anaesthesia
• Malignant hyperthermia
• Postoperative nausea and vomiting

• Patient information
  • Information for patients
  • Patient's guides and more anaesthesia-related information
• Historical
  • History of Anaesthesia society
  • The Unusual History of Ether
  • Conquering surgical pain: Four men stake their claim
  • A History of Anaesthesia at Harvard University
• American Society of Anaesthesiologists
• A medical student's guide to anaesthesia from a patient's perspective
• Gasnet, a comprehensive anaesthesiology resource
• Columbia Encyclopedia-Acupuncture
• Opium in Japan
• Medical Uses of Marijuana
• University of California Pain Alleviation and Anesthesia Exhibit

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