We expect to feel no pain during surgery or at least to have no memory of the procedure, but it wasn’t always so. Till the discovery of general anesthesia in the middle of the 19th century, surgery was performed only as a last resort. Conscious and without pain relief, it was with unimaginable terror, unspeakable agony.
A young US dentist named William Morton searched for a way to relieve pain to boost his dental profits. His efforts were rewarded when he discovered that when small animals or himself inhaled ethyl ether they passed out and became unresponsive. On October 16th, 1846 had anesthetized a young male patient in a public demonstration for the removal of a tumor on the left side of the jaw. This occurred without the patient apparently moving or complaining.
This began the story of general anesthesia, which is now widely regarded as one of the greatest discoveries of all time.
Today, ether and chloroform have been replaced by much safer and more effective agents and anesthesia has been much more developed with discoveries of endotracheal tubes, anesthesia machines, local anesthetics and anesthetic gases, and airway instruments.
Advances in anesthesia have made many new surgical techniques possible, and mortality directly attributable to anesthesia is now rare. Most recent advances have contributed to an important decrease in morbidity from anesthesia and to an increase in the quality of perioperative management.
In 21st century the digital revolution has brought newer technology to the art and science of anesthesiology. The emergence of video laryngoscopes has made it possible to intubate the trachea in any difficult airway situation. Many regional blocks are now possible and are more accurately and safely given with the advent of ultrasonography. Minimally invasive cardiac surgeries are now being performed under regional anesthesia blocks. Transplant anesthesia, and robotic anesthesia are now being safely practiced. Standards of anesthesia and patient safety are much more improved with more advanced monitoring like BIS, cerebral oximeter, and many other monitoring devices used intraoperatively.
The roles of anesthetists continue to broaden as anesthesia now encompasses the intensive care unit, acute and chronic pain management and also general emergencies.
21st century anesthesia with its sophisticated techniques and drugs seems worlds apart from the early usage of ether and chloroform but it should not be forgotten that these advances are not only because of current but also because of past researchers and scientists.
Dr. Mahantesh S Mudakangoudar
