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Anaesthesiology
The History of Anesthesia
Built from Barash Clinical Anesthesia, 9th Edition
What’s inside
13 sections · 199 slides
Overview
- Scope of this topic
- Surgery before anesthesia
- Why the history matters
- Roles the modern anesthesiologist fills
Anesthesia Before Ether
- Nerve compression as early anesthesia
- Refrigeration anesthesia
- Mesmerism and surgical pain
- Mandragora and the soporific sponge
- Alcohol and laudanum
- Hanaoka's mafutsuto in Japan
- Preparation and discovery of nitrous oxide
- Humphry Davy and the missed opportunity
The Discovery of Ether Anesthesia
- Hickman's carbon dioxide experiments
- Origins and long neglect of diethyl ether
- Clarke's ether anesthetic of 1842
- Crawford Long's first surgical ether
- Horace Wells and nitrous oxide
- Morton's route to ether
- Advantages of ether over nitrous oxide
- The demonstration of 16 October 1846
- The surgical amphitheatre where ether was first demonstrated
- Design of Morton's inhaler
- Morton's ether inhaler of 1846
- The ether controversy
- Spread of ether anesthesia worldwide
- Steps from ether frolic to public demonstration
Chloroform and Childbirth
- Simpson's discovery of chloroform
- Religious objections to obstetric anesthesia
- Chloroform a la reine
- John Snow
- Snow's experiments and writings
- A Snow-type chloroform inhaler
Control of the Airway
- Early control of the upper airway
- Macewan's first elective oral intubation
- O'Dwyer's tubes and the Fell-O'Dwyer apparatus
- Franz Kuhn's intubation technique
- Kirstein's direct-vision laryngoscope
- Jackson, Janeway and Dorrance blades
- Miller and Macintosh blades
- Where each blade tip sits
- Accidental invention of the Macintosh blade
- Curved laryngoscope blades in a range of sizes
- Magill's wartime introduction to anesthesia
- Development of blind nasal intubation
- Magill tubes
- Guedel's cuffed tracheal tube
- Guedel's demonstration of the cuff seal
- The dunked dog demonstration
- One-lung anesthesia and double-lumen tubes
- Robertshaw tubes and centimetre markings
- Rigid and flexible bronchoscopes
- Bullard and Wu scopes
- Origin of the laryngeal mask airway
- Laryngeal mask airway components
- Ways of securing the airway
Anesthesia Delivery Systems
- Snow's ether inhalers
- Snow's inhaler of 1847
- Clover's chloroform bag and gas cylinders
- The first freestanding anesthesia machines
- Foregger and McKesson machines
- Ayre's T-piece and its modifications
Ventilators and Carbon Dioxide Absorption
- Early attempts to keep the open chest inflated
- The first intermittent positive-pressure devices
- The Copenhagen polio epidemic of 1952
- Iron lungs in North America
- A negative-pressure tank ventilator
- Bennett, Bird and bag-in-bottle ventilators
- Purpose of carbon dioxide absorption
- The first carbon dioxide absorbers
- Waters' carbon dioxide absorber
- Sword's circle system
- Flowmeters and rotameters
- The Copper Kettle
- Calculating concentration on a universal vaporizer
- The TECOTA and agent-specific vaporizers
Patient Monitors and Safety Standards
- The role of monitoring
- Clover and the argument over the pulse
- Blood pressure measurement in the operating room
- Precordial and esophageal stethoscopes
- Electrocardiography in anesthesia
- Origins of pulse oximetry
- Capnography and anesthetic gas analysis
- Origin of anesthesia equipment standards
- Uniform connector dimensions
- Engineered barriers against gas mix-ups
- Ethyl chloride and ethylene
- Discovery of cyclopropane
- Vinethene and international collaboration
- The explosion problem and fluorine chemistry
- Fluroxene, the first fluorinated anesthetic
- Suckling's design of halothane
- How halothane was created
- Methoxyflurane and fluoride nephrotoxicity
- Enflurane and isoflurane
- Desflurane, sevoflurane and xenon
- The hollow needle and syringe
- Early intravenous surgical anesthesia
- The first barbiturates
- Thiopental
- Ketamine
- Etomidate
- Propofol
Local Anesthetics, Opioids and Relaxants
- Isolation of cocaine
- The coca plant
- From cocaine to the amino esters
- Lidocaine and the amino amides
- Bupivacaine and ropivacaine
- Opium and the isolation of morphine
- Meperidine, the first synthetic opioid
- Paul Janssen's phenylpiperidines
- Remifentanil and ketorolac
- Origins and early uses of curare
- Antagonists and the Gills' curare
- Bennett's 'shock absorber' and Lawen's neglected work
- Griffith and Johnson, 23 January 1942
- What relaxants changed
- Standardizing the dose of curare
- The rabbit head-drop assay
- Succinylcholine and blockade monitoring
- Steroidal and benzylisoquinolinium relaxants
Antiemetics
- Postoperative nausea, vomiting and aspiration
- Historical treatments for nausea
- The first effective antiemetics
- Droperidol, steroids and the 5-HT3 antagonists
Anesthesia Subspecialties
- Koller's discovery of topical cocaine
- The Heidelberg announcement
- Halsted, Hall and injected cocaine
- Corning, Bier and the claim to spinal anesthesia
- Quincke's lumbar puncture
- Bier and Hildebrandt's self-experiment
- Early refinements of spinal technique
- Braun and conduction anesthesia
- Barker, baricity and hyperbaric solutions
- Hypobaric solutions
- Continuous spinal anesthesia and the Tuohy needle
- The first continuous epidural and caudal anesthesia
- The Pages-Dogliotti technique
- Cushing's regional anesthesia and the Bier block
- Approaches to the brachial plexus
- Labat, Rovenstine and pain medicine
- The taboo on cardiac surgery
- Anesthesia for the first Blalock-Taussig shunt
- Cardiopulmonary bypass
- Monitoring in cardiac surgery
- Cardioplegia, heparin reversal and echocardiography
- The first dedicated pediatric anesthetists
- Ayre's T-piece in children
- Leigh, Belton, Deming and Smith
- Gordon Jackson Rees and neonatal anesthesia
- Virginia Apgar and the newborn score
- The first pediatric intensive care units
- Trephination and the first craniotomies
- Horsley, Cushing and dedicated personnel
- Regional anesthesia for cranial surgery
- Scientific foundations of neuroanesthesia
- Twilight sleep
- Restraint and decline of twilight sleep
- The dark ages of obstetric anesthesia
- First attempts at blood transfusion
- Transfusion of physiologic solutions
Building the Specialty
- The first American society and McMechan
- The first journal and research society
- Kaye and the International College of Anesthetists
- Ralph Waters' early career
- Research and review in the Madison department
- Status lymphaticus
- Lundy's Anesthetists' Travel Club
- The Aqualumni
- Creating the American Board of Anesthesiology
- Anesthetist or anesthesiologist
- How the specialty was built
Conclusions and Key Points
- Where anesthesiologists work today
- Key points from the history of anesthesia
- Recurring patterns in the history
- References
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- References (continued)
- Barash, Cullen, and Stoelting's Clinical Anesthesia, 9th Edition