The Development of Anaesthesia - Essay Example

?Anesthesia and the Alleviation of Human Suffering Before anesthesia was discovered, surgery was a painful affair. It is, hence, considered as last option, particularly in saving a life. Surgeons turn to crude methods such as drugging the patient to sleep or hypnotizing them in order to give relief. Indeed, one can just imagine how horrifying the process is, when doctors have to cut up people and these in turn could feel every slice of the knife and every movement as the surgeon went about his business. The discovery, hence, of anesthesia is one of the most important milestones in modern medical practice. It not only paved the way for a more effective and efficient surgery but that it also provided a way to treat and operate patients in a most humane method. History The development of anesthesia followed a gradual and logical evolution. Between 9th and 13th centuries, the primitive methods that doctors used to help in surgeries were poultices of herbs such as Mandrake leaves, black nightshade and poppies, which constituted the soporific sponge, widely used to induce unconsciousness prior to surgery (1). Intoxication was also a preferred approach as deep sleep and unconsciousness were the only means to undergo surgical procedure. It was only during the 18th century when the beginnings of anesthesia emerged. In 1840, ether was discovered. The most notable incident that brought attention to this new medical discovery was the public ether administration by William Thomas Green Morton to Gilbert Abbott at Massachusetts General Hospital. Morton was a dentist and the procedure on Mr. Abbott involved the painless removal of a tumor from the patient’s neck. This was historic moment and the practice of using ether swiftly spread. A parallel development in India also transpired within the same period. In 1847, chloroform anesthesia was administered in Calcutta and its use became prevalent in India by 1848. According to Roy and Saha, this version proved less effective since several people died after it was administered (1). This was confirmed the James Young Simpson’s experience with the chemical (2). In his practice, he used chloroform because it was considered more potent than ether but it was found to have adverse side effects such as liver damage and sudden death (1). Essentially, what was discovered during this period was general anesthesia, which was the combination of nitrous, ether and chloroform. This turning point is widely seen as a critical contributor in the manner how surgery has developed rapidly as a science. The succeeding years saw the further improvement of anesthesia. For instance, in the 1920s, local anesthesia was developed. This is the type of anesthesia inhibits the sensory perception of a specific part of the body. Schuttler cited that this led to the development of peripheral plexus blockades, lumbar peridural anesthesia and some versions of spinal anesthesia (3). Another important breakthrough was perhaps the discovery of halothane during the 1950s, which addressed the problems in the combination of ether and chloroform: flammability and unfavorable kinetics (4). The combination of halogen and ether, or more specifically, the refinement of the use of halogenated ether built on the successes and efficacies of earlier forms of anesthesia while introducing new advantages at the same time. Through the years, more developments and improvements followed, which included, not only anesthetic technologies, but also methodological innovations and best practices as well the growing understanding and specialization of anesthesia as an area in medical practice. Impact on Medical Practice As has been cited earlier, anesthesia provided the impetus for the development of surgery as a science. When - in the past - it was considered a last resort, today the case is different. Surgery is one of the most effective procedures in medicine, saving lives in efficient and painless manner. By diminishing pain or eliminating it entirely in the equation, anesthesia has enabled surgeons to take more time when undertaking surgical procedures and be more accurate and capable in undertaking complex procedures (1). Suresh contributed further to this theme when he underscored the complex nature of medical practice, particularly of surgery (5). He explained that “this complexity may lead to errors, and these errors may lead to patient harm,” and that “the ability to prevent errors from occurring” as well as the mitigation of medical errors are essential to safe medical practice (5). Anesthesia also humanized surgery. In the pre anesthesia period, the surgical procedure was cruel. Morton himself concisely summarized anesthesia’s contribution in this respect. He stated that “before whom in all time surgery was agony” (6). To underscore this point further, one can turn to a graphic account on how surgery was performed before without anesthesia: Fanny Burney, a literary figure of the 19th century, described her experience, which involved seven male assistants to hold her down: “When the dreadful steel was plunged into the breast-cutting through veins-arteries-flesh-nerves-I needed no injunction not to restrain my cries… So excruciating was the agony… I then felt the knife racking against the breast bone - scraping it!” (6). Anesthesia, hence, is some culmination in human civilization’s attempt to improve on the technology, procedures and tools in medical practice so that patients experience when he is treated for his ills is as comfortable and dignified as possible. All in all, the development of anesthesia and the emergence of the medical field devoted to its specialization have resulted in unprecedented success in surgery. According to Orebaugh, many surgeries that were deemed impossible to perform before could now be undertaken with utmost efficiency and convenience on the part of the patient (7). Beginning in the twentieth century, anesthesia and the new medical professional specializing in its use became indispensable components in modern medical practice. Future Trends Anesthesia is already inextricably linked to surgery. As such, both of these disciplines are pushing each other towards faster development, as one could not afford to be outpaced by the other. So the future for anesthesia is quite bright. One particular area would have to be the further integration of technology in the practice. For example, there is the case of mechanization of anesthetic procedures. One of the possibilities is the anesthetic “autopilot”, which involves a computer program controlling the administration of anesthesia to patients (8). The idea is that there will come a time when the only human in the operating room will be the patient. Certainly, this is still quite far-fetched. But this underpins the trajectory of development. This transition from humans to machine is widely seen as favorable development as it would eliminate the rate of human error. There are also those who see further improvements in practices, in terms of safety, technique, innovations and expertise (9). These are usually coming from the sectors that advocate the need for human touch in treating the sick. But it is clear from these trends that the ultimate goal for whatever trend or innovations that would be introduced in the future would still be aligned with the core aim why anesthesia has been discovered in the first place: the need to alleviate human suffering. Out of all the points raised by this paper, it is clear that anesthesia is a milestone in the history of medicine. It paved the way for the further specialization of surgery and, hence, benefitted the many surgical patients whose lives could have been at risk had they lived before anesthesia was discovered. Anesthesia also humanized medical practice. It is at the forefront in the civilized care delivery model where patients are treated with dignity. References 1. Roy, M and Saha, E. Anaesthesia. Kolkata: Academic Publishers, 2008. 2. Bynum, WF and Porter, R. Companion Encyclopedia of the History of Medicine. London: Routledge, 2013. 3. Schuttler, J. 55th Anniversary of the German Society for Anaesthesiology and Intensive Care. Berlin: Springer, 2012. 4. Coatzee, A. Principles of anaesthesia for the undergraduate student. Stellenbosch: Sun Press, 2008. 5. Suresh, M. Shnider and Levinson's Anesthesia for Obstetrics. Baltimore, MD: Lippincott Williams & Wilkins, 2013. 6. Barash, PG, Cullen, B, Stoelting, R, Cahalan, M and Stock, C. Clinical Anesthesia. Philadelphia: Lippincott Williams & Wilkins, 2012. 7. Orebaugh, S. Understanding Anesthesia: What You Need to Know about Sedation and Pain Control. Baltimore, MD: JHU Press, 2011. 8. O’Donnell, A. Anaesthesia: A Very Short Introduction. Oxford: Oxford University Press, 2012. 9. Ehrenwert, J, Eisenkraft, J and Berry, J. Anesthesia Equipment: Principles and Applications. Philadelphia: Elsevier Health Sciences, 2013. Read More