DOMESTIC ANESTHESIOLOGY IN THE FIRST HALF OF THE XX CENTURY: SCIENTIFIC PRIORITIES

Abstract

The article notes that the problems of anesthesia in the first half of the XX century were developed by joint efforts of surgeons and anaesthesiologists, who distinguished their discipline as a narrow specialty from clinical medicine. Local anesthesia by the method of creeping infiltrate, anatomically developed and physiologically grounded prof. A.V. Vishnevsky, has become very popular not only in our country, but also abroad. It is shown that many other surgeons began to perform under local anesthesia surgical interventions on the organs of the thoracic cavity, esophagus, lungs, and heart. About 90% of lung operations for tumors, bronchiectasis, tuberculosis were performed using the creeping infiltrate method under local anesthesia. It was stressed that in the 50s of the 20th century it became evident that in many cases of severe and deeply traumatic surgery, especially on the chest cavity, only protection against pathological reflexes in the field of intervention achieved by the Novocaine blockade is insufficient, since it was necessary to preserve and maintain the function of the whole organism. The use of barbiturates in surgery has received a lot of attention, and a technique has been developed that made it possible to carry out large operations lasting up to 2 hours or more (under the action of hexenal). It was shown that hexenal anesthesia was not injected and almost all of it was abandoned. In the post-war period, intratracheal ether-oxygen anesthesia began to be used in surgical practice. It was noted that the absence of vomiting, the patient’s open face, bronchial tamponade, the ability to increase intrabronchial pressure, spread the lungs, provide artificial ventilation and maintain a high oxygen content in the blood - all this contributed to the spread of this method. Consequently, anesthesia in surgical interventions, the use of modern pharmacological agents and anesthesia at that time, turned into special problems, the solution of which became practiced by doctors specially trained in the field of therapy, physiology, pharmacology and pathological physiology. Thus, a new discipline arose, anesthesiology, and all preparation for surgery, anesthesia during surgery and an early postoperative period is transferred to the direct management of anesthesiologists.