Published online by Cambridge University Press: 13 August 2009
Key learning points
Understand historical events in anaesthesia
Explore the place of present-day changes in anaesthetic practice
Recognise the importance of evidence in developing a body of anaesthetic knowledge
Develop a reflective approach to anaesthetic practice
The past three centuries have brought many changes to the care of patients undergoing anaesthesia. Many of those changes have been at the hands of inspirational doctors who many now regard as pioneers of present-day anaesthesia.
Before anaesthesia, surgery was a traumatic event, full of pain and suffering of an unimaginable degree, which often led to patients' death. It is important to understand the horror and brutality of early surgery without anaesthesia, to understand the real value of anaesthesia today. It is hard to imagine how patients must have suffered under the knife when, for example, cutting through the perineum, opening the bladder, extracting a stone and then sewing up the wounds. Meanwhile the patient would have been in unbearable agony, suffering convulsions and muscle spasms, may have gone into deep shock and would have most probably died of the experience.
Joseph Priestly, in 1777, developed one of the most valuable contributions to present-day anaesthesia. Arguably the first anaesthetist, Priestly discovered the value of nitrous oxide for anaesthesia. The work of Humphrey Davy in 1800 described the analgesic action of nitrous oxide, thus confirming its use for anaesthesia. Nitrous oxide is an anaesthetic gas which anaesthetists still use today to aid the delivery of volatile agents and to control the patient's conscious level and pain.
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