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  Anesthesia

Anesthesia is the medical procedure used to block pain. The Greek root ‘an’ means ‘not or without’ and ‘aesthetos’ means ‘perceptible, able to feel.’ The word was created or coined by Oliver Wendell Holmes, Sr. in 1846.

Anesthesia can include analgesia, hypnosis, amnesia, relaxation and homeostasis. Analgesia means to block the perception of pain. Hypnosis produces unconsciousness. Amnesia prevents memories from being created. Relaxation is used to prevent undesirable movement or muscular reflexes. Homeostasis prevents normal body functions – like keeping heart rate steady or blood pressure level.

Anesthesia
Anesthesia


There are three types of anesthesia: general anesthesia used for major surgery; local anesthesia used for small procedures; and regional anesthesia often used for pain control.

Sedation is the administration of drugs that makes a patient relaxed or more comfortable – but does not cause loss of feeling like anesthesia.

History

Anesthesia began before history, with herbal anesthesia. Cannabis and opium were the first herbs used. These were ingested or burned with the smoke being inhaled. In Medieval times, mandrake and henbane concoctions were used as anesthesia

Medical practitioners in China developed anesthesia using acupuncture. In 1804, an operation on a women’s breast was performed by Japanese surgeon Hanaoka Seishu. He combined Chinese herbal medicine and Western surgical techniques. He used a compound called Tsusensan, a combination of plants – including Datura metel and Aconitum.

Ether was discovered in 1540 and was used in the United States in 1842 before an operation to remove a cyst.

In the 1820s, Henry L. Hickman used carbon dioxide to perform surgery. In 1795, Nitrous Oxide was discovered to have anesthesia power by Humphrey Davy. It wasn’t used for surgery until 1844 by Horace Wells for a tooth extraction.

William Thomas Green Morton, a dentist performed the first public operation using ether for the removal of a tumor from a patient’s neck. Morton tried to keep control over the compound, naming it Letheon and obtaining a US patent. In England, either was replaced with chloroform. Chloroform was discovered in 1831. It was used by James Young Simpson. In 1853 John Snow gave chloroform to Queen Victoria during the birth of Prince Leopold. Chloroform was not as safe as ether, and many medical practitioners were pressured into using it without the proper training.

Despite Morton's efforts to keep "his" compound a secret, which he named "Letheon" and for which he received a US patent, the news of the discovery and the nature of the compound spread very quickly to Europe in late 1846. Here, respected surgeons, including Liston, Dieffenbach, Pirogoff, and Syme undertook numerous operations with ether.

The Profession

In the United Kingdom, physicians who develop an anesthetic plan, administer the anesthesia and plan the post/pre operative plan are called Anesthetists. In the United States, they are called anesthesiologist.

Other specialists are similar to anesthesiologists such as intensive care medicine and pain management. In the United States nurse practitioners that specialize in anesthesiology are CRNAs.

Anesthesia Choices:

Local anesthesia, general anesthesia, regional anesthesia and conscious sedation are the choices available for anesthesia. The first local anesthesia used effectively was cocaine. Cocaine was first used in 1884 in ophthalmic surgery by Karl Koller. Prior to that numbing with salts and ice were used, but with very unsatisfactory results. Cocaine is responsible for a few derivatives of local anesthesia: Procaine, Eucaine, Stovaine and lidocaine.

Local anesthesia is used when a patient needs to stay conscious for health or practical reasons typically used for dental work or skin biopsies or stitches. Conscious sedation is administered via IV. It is used for procedures such as colonoscopy. Regional anesthesia is used to block sensation in certain areas of the body – such as the lower half for labor or the eye. Regional anesthesia is injected around a single nerve in the are area that is responsible for the area of surgery or procedure. Regional anesthesia has little effect on the heart, lungs or brain. With regional anesthesia recovery and pain management are uncomplicated. General Anesthesia is used for more complicated procedures. General anesthesia medications are given via IV or inhalation or a combination. These medications suppress protective reflexes such as coughing or gagging and possible breathing. A mask or breathing tube is usually required during general anesthesia.

The procedure being performed and the patient’s health are the deciding factors for the type of anesthesia used.

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